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The etiology and pathogenesis of anxiety disorders were still unknown with limited progress in treatment， and had a low cure rate and a high relapse rate. Oxytocin has attracted attention in recent years due to its anxiolytic effect， especially validated in animal experiments， but there are few studies in humans. Therefore， the purpose of this paper is to illustrate the pathological mechanism of anxiety through review researches on oxytocin and anxiety in recent years. Anxiety disorder is one of the most common mental disorder， and the imbalance of neurotransmitters is one of the pathogenesis. As a common neurotransmitter in the brain， oxytocin participated in the process of anxiety regulation. The purpose of this article is to summarize the research related to oxytocin to explore its possible mechanism of regulating anxiety， and to provide new ideas for diagnosis and treatment of anxiety disorders in combination with the clinical findings. ［Funded by Zhejiang Health Science and Technology Plan （number， 2022KY367）］.
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Objective:To investigate the correlation between serum thyroglobulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab) cconcentrations and arteriosclerosis development in middle-aged and older adult patients with depression.Methods:A total of 200 middle-aged and older adult patients with depression who received treatment in the Third People's Hospital of Huzhou from January 2018 to October 2019 were included in this study. They were divided into four groups ( n = 50/group) according to TG-Ab and TPO-Ab test results: TG-Ab-positive (group 1), TPO-Ab-positive (group 2), TG-Ab-positive and TPO-Ab-positive (group 3), TG-Ab-negative and TPO-Ab-negative (control group). Serum thyroid hormone level, ankle-brachial pressure index (ABI), brachial-ankle pulse wave velocity, and the incidences of intima-media thickening and plaque formation in the lower extremity arteries were compared between groups. Results:Total thyroxine concentration in the control group, groups 1, 2 and 3 was (89.96 ± 2.45) nmol/L, (101.29 ± 3.35) nmol/L, (90.09 ± 2.70) nmol/L, (97.55 ± 2.57) nmol/L, respectively. There was a significant difference in total thyroxine concentration between groups ( F = 3.85, P < 0.05). Brachial-ankle pulse wave velocity in the control group, groups 1, 2, and 3 was (1 327.55 ± 67.78) cm/s, (1 510.36 ± 83.05) cm/s, (1 422.71 ± 71.40) cm/s, (1 533.95 ± 87.01) cm/s, respectively. There was a significant difference in brachial-ankle pulse wave velocity between groups ( F = 65.12, P < 0.05). The incidence of intima-media thickening in the control group, groups 1, 2, and 3 was 18% (9/50), 50% (25/50), 32% (16/50), 60% (30/50), respectively. The incidence of plaque formation in the control group, groups 1, 2, and 3 was 22% (11/50), 56% (28/50), 40% (20/50), 70% (35/50), respectively. There were significant differences in intima-media thickening and plaque formation between groups ( χ2 = 21.83, 25.77, all P < 0.001). Logistic multivariate regression analysis showed that age ( OR = 0.953) and TG-Ab ( OR = 1.116) were independent risk factors for developing arteriosclerosis in middle-aged and older adult patients with depression ( P < 0.05). Conclusion:TG-Ab-positive results are an independent risk factor for developing arteriosclerosis in middle-aged and older adult patients with depression. TPO-Ab-positive results have a synergistic effect on the occurrence and development of arteriosclerosis in middle-aged and older adult patients with depression. Monitoring serum TG-Ab and TPO-Ab concentrations is of great clinical significance for the prevention and treatment of arteriosclerosis in middle-aged and older adult patients with depression.
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Objective To study clinical data retrospectively and demonstrate the optimal injection site of adductor canal block by performing a cadaveric study.Methods Clinical part:clinical data from 19 patients,11 males and 8 females,aged 21 85 years,ASA physical status Ⅰ-Ⅲ,who received ultrasound guided adductor canal block were retrospectively collected.Among whom 9 received a mid-distance injection of 10 ml of 0.5％ ropivacaine and 10 received an injection of the same medication at the outlet of adductor canal.The primary endpoint was complete absence of cold sensation to ice cube on the medial side of calf at 30 minutes and 24 hours after injection.Cadaveric part:40 lower limbs,20 males and 20 females,were finally analyzed in the study.The distances from the anterior superior iliac spine (ASIS) to the medial tibial condyle,from ASIS to the entrance of the adductor canal,from ASIS to the exit of the canal (adductor tendinous opening),from ASIS to the site where sa phenous nerve emerges through the aponeurotic covering were measured respectively.The length of adductor canal,the relative location of adductor canal and the site where saphenous nerve pierces in the lower limbs were calculated.Results Clinical part:all 19 cases were successfully recorded with complete absence of cold sensation at 30 minutes after injection of local anesthetic and complete sensory recovery at 24 hours after injection.Cadaveric part:in all specimens,saphenous nerve enters adductor canal and coursed down until emerging at very close to the distal end of the canal with the saphenous branch of descending genicular artery.The length of the adductor canal was (10.0±2.1) cm.The entrance and the exit of adductor canal and the emerging site of the saphenous nerve located along the (54.7±3.0) ％,(76.0％±3.8) ％ and (74.1±3.2) ％ of sartorius muscle,respectively.Conclusion Performing ultrasound-guided adductor canal block at either the outlet of adductor canal or mid-distance of thigh can achieve comparable blockade of saphenous nerve.Cadaveric study implicated that the optimal injection site for adductor canal block should be the lower one-third of sartorius muscle.Ultrasound-guided injection of local anesthetics next to the descending genicular artery may possibly become a promising new method of saphenous nerve block.
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Objective In view of the trend of networking development in modern high education and the characteristics of students' strong self-learning ability, Peking Union Medical College established a multimedia morphological teaching website from 2013 including human anatomy, neuroanatomy, histology and embryology.Methods According to the teaching demand, the use of the ASP script, combined with Mysql database completed the website development, from the interface design to the curriculum, the syllabus, presentations and laboratory videos uploading.Results Through the questionnaire survey, 45% of the students use website more than 3 times a week, and course content column has the highest use frequency (79%).An independent learning platform effect has been achieved.Conclusions After nearly 4 years exploration and practice, multimedia website has become an important part of morphological courses, as a kind of new teaching mode, not only popular for college teachers and students, but also widely used in clinical teaching.
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Objective To observe the effect of risperidone on serum brain derived neurotrophic factor ( BDNF) in first-episode schizophrenic patients. Methods In the treatment group, 90 first-episode schizophrenics were treated with risperidone for 16 weeks, and the dose of risperidone was (3.79±0.88) mg·d-1. Serum BDNF levels were measured before treatment, at 2, 8, and 16 weeks after treatment. The severity of schizophrenia symptoms was assessed by the positive and negative symptom scale ( PANSS) before and after sixteen weeks of treatment. Serum BDNF concentrations were measured in 90 healthy controls. Results BDNF in the control group was (22.867±6.051) ng·mL-1. The serum BDNF levels before treatment and at the end of week 2, 8, 16 after the treatment in the treatment group were (14.256±4.096), (13.078±3.462), (18.001±5.753), (21.089± 6.692) ng·mL-1 , and the serum BDNF level was significantly lower in the treatment group than that in the control group ( P<0.01) . After the treatment, the level of BDNF in the treatment group decreased at first and then increased, compared with that before treatment, the difference was significantly ( P<0.05 or P<0.01) . The level of BDNF in the treatment group at the end of week 16 was not significantly different from that of the control group ( P>0.05) . After treatment, the total score of PANSS scale and its subscales decreased, the difference was significantly (P<0.01). At the end of week 16, the PANSS subscale reduction rate was positively correlated to the serum BDNF concentration change (r=0.499, P=0.001). The change rate of serum BDNF concentration at the end of week 16 was not correlated with the dose of risperidone (r=0.103, P=0.335). Conclusion BDNF is abnormal in the first episode of schizophrenia, which can be improved by risperidone treatment.
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Objective To observe the effect of risperidone on serum brain derived neurotrophic factor ( BDNF) in first-episode schizophrenic patients. Methods In the treatment group, 90 first-episode schizophrenics were treated with risperidone for 16 weeks, and the dose of risperidone was (3.79±0.88) mg·d-1. Serum BDNF levels were measured before treatment, at 2, 8, and 16 weeks after treatment. The severity of schizophrenia symptoms was assessed by the positive and negative symptom scale ( PANSS) before and after sixteen weeks of treatment. Serum BDNF concentrations were measured in 90 healthy controls. Results BDNF in the control group was (22.867±6.051) ng·mL-1. The serum BDNF levels before treatment and at the end of week 2, 8, 16 after the treatment in the treatment group were (14.256±4.096), (13.078±3.462), (18.001±5.753), (21.089± 6.692) ng·mL-1 , and the serum BDNF level was significantly lower in the treatment group than that in the control group ( P<0.01) . After the treatment, the level of BDNF in the treatment group decreased at first and then increased, compared with that before treatment, the difference was significantly ( P<0.05 or P<0.01) . The level of BDNF in the treatment group at the end of week 16 was not significantly different from that of the control group ( P>0.05) . After treatment, the total score of PANSS scale and its subscales decreased, the difference was significantly (P<0.01). At the end of week 16, the PANSS subscale reduction rate was positively correlated to the serum BDNF concentration change (r=0.499, P=0.001). The change rate of serum BDNF concentration at the end of week 16 was not correlated with the dose of risperidone (r=0.103, P=0.335). Conclusion BDNF is abnormal in the first episode of schizophrenia, which can be improved by risperidone treatment.
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Objective To explore the efficacy of aripiprazole in patients with bipolar disorder D2 receptor and 5 -HT1A receptor partial agonists and analyze 5 -HT2A receptor antagonism.Methods From January 2013 to January 2015,113 patients came to our hospital for treatment of bipolar disorder,in accordance with the order of admission,were divide into aripiprazole group (47 cases)and control group (66 cases).The control group was given venlafaxine,aripiprazole group was given aripiprazole treatment on the basis of the control group.SDS,BRMS score and therapeutic effect were compared between the two groups before and after treatment.Results The SDS,BRMS scores were decreased after treatment in the two groups,compared with before treatment,the differences were statisti-cally significant (t =31.3587,36.1207;all P <0.05 );and the aripiprazole group decreased more significantly than the control group,the SDS,BRMS scores of the two groups after treatment had statistically significant differences [SDS (31.8 ±4.3)points vs (28.7 ±3.6)points,BRMS (6.5 ±0.2)points vs (5.5 ±0.2)points,t =4.110 7,26.197 0, all P <0.05 ].The total effective rate of the aripiprazole group was 97.9%,which was significantly higher than 89.4% of the control group (u =3.365 9,P =0.000 8).The incidence rate of adverse reactions such as nausea, vomiting,drowsiness,anxiety and heart rate in the aripiprazole group was significantly lower than the control group (all P <0.05 ).Conclusion Aripiprazole for bipolar disorder patients with D2 receptor and 5 -HT1A receptor has partial agonism,of 5 -HT2A receptor with role constraints,can effectively improve the effect of treatment of patients,reduce the incidence of adverse reactions.
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<p><b>OBJECTIVE</b>To assess the association of BDNF gene Val66Met polymorphism with efficacy of antidepressant treatment and plasma BDNF level.</p><p><b>METHODS</b>Two hundred and forty-nine ethnic Han Chinese patients with depression(study group), who have met the diagnostic criteria of DSM-IV, were prescribed with venlafaxine or paroxetine. Two hundred and two healthy individuals were recruited as the control group. General demographic information such as gender, age, educational status, occupation, and marriage status were collected. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th, 6th week of treatment. PCR-restriction fragment length polymorphism was applied to determine the Val66Met polymorphism of the BDNF gene in the two groups. Plasma BDNF concentration was measured with ELISA before and after 6 weeks of treatment.</p><p><b>RESULTS</b>No significant differences have been found in HAMD scores and reduction of HAMD scores on the baseline and at the end of 1 st, 2nd, 4th, 6th weeks of treatment for each genotype. Nor were significant differences found in the Val66Met genotypes and allelic frequency between patients who achieved remission or not after 6 weeks' treatment as well as the healthy volunteers. The plasma BDNF level in depression patients was lower than that in healthy controls. The BDNF level has increased significantly after 6 weeks' treatment with both venlafaxine and paroxetine, but was still lower than the healthy controls. The BDNF level in the patients achieved remission who were treated with venlafaxine was similar to the normal controls, while those treated with paroxetine was still lower than normal controls. The BDNF level in patients who have not achieved remission was lower than normal controls. The BDNF level was not associated with the Val66Met polymorphism on the baseline and the end of 6th week.</p><p><b>CONCLUSION</b>No association has been found between the efficacy of venlafaxine or paroxetine and the BDNF Val66Met polymorphism. The BDNF level of patients with depression is significantly lower than healthy controls on the baseline, and can be enhanced with the treatment. Particularly, the BDNF level in patients who achieved remission after the treatment of venlafaxine can rise to normal. The level of BDNF has certain value in the forecasting of efficacy in the anti-depression therapy. BDNF level is not associated with the Val66Met polymorphism of the BDNF gene.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antidepressivos , Usos Terapêuticos , Fator Neurotrófico Derivado do Encéfalo , Sangue , Genética , Depressão , Sangue , Tratamento Farmacológico , Genética , Polimorfismo GenéticoRESUMO
Objective To investigate the effects of quetiapine on serum levels of brain-derived neurotrophic factors ( BDNF) and the correlation between BDNF and psychiatric symptoms and cognitive function in patients with first-episode schizophrenia. Methods Eighty patients with first-episode schizophrenia ( treatment group) were treated with quetiapine orally for 4 weeks,at initial dose of 100 mg·d-1 and average dose of (580±120) mg·d-1 . The psychiatric symptoms were evaluated by using the positive and negative syndrome scale ( PANSS) . The cognitive function was assessed by using Wisconsin cards sort test ( WCST) . The serum BDNF level was detected with enzyme-linked immunosorbent assay ( ELISA) . Results The serum level of BDNF was markedly lower in schizophrenic patients before[(13. 72±8. 79) ng·mL-1,P<0. 01] and after treatment[(18. 02±9.06) ng·mL-1,P<0.05]in comparison with normal controls(23. 67±10. 13) ng·mL-1]. After treatment,the PANSS total scores and subscale scores decreased,WCST number of categories and the number of correct answers increased,and the number of wrong answers reduced. There was a positive correlation between the serum BDNF and negative symptoms ( SANS) ( r= 0. 54, P=0. 032),and the number of correct answers. Conclusion The quetiapine significantly increases serum level of BDNF in schizophrenia patients,which correlates positively with improvements in symptoms and cognitive function.
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[Objective] To study the effect and reliability of fluoxetine on depression and symptoms in cancer patient,and to assess the overall quality of life before and after treatment.[Methods]We treated 54 cancer patients with depression by Fluxetine for 8 w,at the same time,evaluated their emotion state,change of quality of life and the adverse effect with HAMD,HAMA,TESS and laboratory tests.[Results]After 8 w,patients’ scores of anxiety and depression decreased significantly from the baseline,effective rates were 82.4% and 96.3% respectively.3 domains of quality of life (physiology,psychology and independence) became much better than those of baseline.The side effect of fluxetine was small.[Conclusion]This study shows that fluoxetine can reduce the depression and anxiety symptoms in cancer patients.
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BACKGROUND: The basic way for the releasing pattern of secretory granules of neurohypophysis is still not clear, neither is the extracellular normal transport route of neurohypophysis polypeptide hormones to enter the cerebrospinal fluid.OBJECTIVE: To provide the morphological evidences for the structural foundations of the releasing pattern and extraeellular normal transport route for secretory granules or polypeptide hormones of neurohypophysis by observing the structure of rats' neurohypophysis.DESIGN: Randomized controlled study.SETTING: Department of human anatomy in a university.MATERIALS: The experiment was completed in the Department of Human Anatomy of Hebei Medical University from May 2003 to January 2004. Twelve healthy clean grade adult male Sprague-Dawley rats with a body mass of about 300 g were supplied by the Experimental Animal Center of Hebei Province.METHODS: The 12 rats were randomly divided into 3 groups with 4 rats in each group. The neurohypophysises of each group were respectively observed with light microscope, transmission microscope and scanning electron microscope.MAIN OUTCOME MEASURES: The microstructure and ultrastructure of the neurohypophysis.RESULTS:All 12 rats entered the final analysis. In the coronary section of rat hypophysis, pars distalis, pars intermedia and pars nervosa were discernable under the light microscope. Under the transmission electron microscope, the neurohypophysis was composed of unmyelinated nerve fibers, pituicytes and connective tissue abound in blood capillaries. The endothelium of the blood capillary belonged to the fenestrated type(50 nm), separated from perivascular space by basement membrane. The intact secretory granules (100 -300 nm) coated with membrane existed not only in the endings of the unmyelinated nerve fibers but also occasionally in perivascular space. Under the scanning electron microscope, the pituitary capsule was composed of simple squamous epithelial cells and subepithelial connective tissue. Many irregular epithelial openings(2-5 μm) were observed among epithelial cells. Secretory granules were seen frequently near the epithelial opening.CONCLUSION: The releasing pattern of secretory granules or polypeptide hormones of neurohypophysis involves a whole-releasing pattern together with granular membrane. After released into perivascular space, they enter easily into cerebrospinal fluid via interspace of tissue and epithelial openings rather than into blood circulation through the walls of capillaries, and then into the cerebrospinal fluid.
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Objective:To investigate the change and related factors of nitric oxide,nitric oxide synthase level and cerebral blood flow(CBF) in panic disorder.Methods:30 patients with panic disorder,30 patients with generalized anxiety disorder and 22 normal controls entered the study.Serum level of NO and NOS were assayed.Cerebral blood flow were measured with TCD.Results:The concentration of NO was significantly lower in panic disorder group in comparison with GAD group.There was no significant difference in NOS level between panic disorder group and the control group.Cerebral blood peak flow velocity in the left and right middle cerebral artery and mean cerebral blood flow velocity in the right middle cerebral artery were lower than normal control group and the difference were very significant.Cerebral blood peak flow velocity in the right vertebral artery was lower than those of GAD and NC group.The concentration of NO in panic disorder was correlated with HAMA score negatively.Cerebral blood peak flow velocity in the left middle cerebral artery was correlated with mean Cerebral blood flow velocity in the left middle cerebral artery,peak CBF velocity in the right middle cerebral artery and psychological anxiety positively and correlated to cerebral blood peak mean velocity in the right middle cerebral artery,peak CBF velocity in the right anterior cerebral artery,age and female negatively.Cerebral blood peak flow velocity in the right middle cerebral artery has positive correlation with mean cerebral blood flow velocity in the right middle cerebral artery and peak CBF locity in the right anterior cerebral artery and negative correlation with cerebral blood mean flow velocity in the right anterior cerebral artery. Mean cerebral blood flow velocity in the right middle cerebral artery was correlated to cerebral blood peak flow velocity in the right middle cerebral artery,mean cerebral blood flow velocity in the left middle cerebral artery,cerebral blood mean flow velocity in the right anterior cerebral artery and NO level positively and age,cerebral blood peak flow velocity in the left middle cerebral artery and cerebral blood peak flow velocity in the right anterior cerebral artery negatively.Cerebral blood peak flow velocity in the right vertebra artery has positive correlation with cerebral blood mean flow velocity in the right vertebra artery and cerebral blood mean flow velocity in the left middle cercbral artery and negative correlation with cerebral blood peak flow velocity in the left anterior cerebral artery and cerebral blood mean flow velocity in the right anterior cerebral artery.Conclusion:The change of NO and cerebral blood flow may be one of the neurobiological mechanisms in panic disorder.To assay the level of NO and measure cerebral blood flow might become approach of diagnosis for panic disorder.
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Objective: To study psychosocial factors and immunity of patients with generalized anxiety disorder Method: 30 patients with generalized anxiety disorder (GAD), 25 patients with neurotic depression and 32 normal controls were collected and assessed with LES (life event scale), SCSQ (simplified coping style questionnaire) and EPQ (Eysenck personality questionnaire) The blood level of IL-2, and rates of NK cell and CD3+ cell of them were also measured Result: The number of negative life events and LEU of negative life events of GAD group were higher that of normal controls, but lower than that of neurotic depression group Their total life events were also more than that of normal controls They had less positive coping than normal controls, more negative coping than both normal controls and patients with neurotic depression Their N score of EPQ was higher than that of normal control and had no significant different to that of patients with neurotic depression They also had higher levels of IL-2 than that of the other two groups There was no significant difference in rates of NK cell and CD3+ cell among all three groups The level of IL-2 was negatively correlated to the number of total life events and L score of EPQ, positively correlated to the rate of NK cell Conclusion: Patients with GAD have psychosocial stress in their life, they incline to negative coping, having unstable mood and impaired immune function Psychosocial stress has influence on immunity