[Changes and Prediction of Social Functional Disability and Quality of Life in Patients with Major Depressive Disorder over the Course of 1-Year Medication].

Objective: To investigate the changes in social function impairment and quality of life and their predictive factors in patients with major depressive disorder (MDD) over the course of 1-year drug treatment. Methods: A total of 54 MDD patients were enrolled for the study. The 17-item Hamilton Rating Scale for Depression (HAMD-17, hereafter referred to simply as HAMD), Sheehan Disability Scale (SDS), and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) were used to evaluate depressive symptoms, social functioning, and quality of life, respectively, at baseline (0), as well as 1 month (1 m), 2 months (2 m), 3 months (3 m), 6 months (6 m), 9 months (9 m), and 12 months (12 m) after medication started. The symptoms and the recovery of social function at different time points was analyzed, and correlation analysis and regression analysis were done to explore the influencing factors of functional recovery. Results: Among the 54 MDD patients, 27 completed the 12-month follow-up, and 2 patients relapsed at 12 m. The total baseline score of SDS (SDS 0) in MDD patients was higher than that in healthy controls ( t=12.161, P<0.001), and the baseline score of Q-LES-Q-SF (Q-LES-Q-SF 0) was lower than that in the controls ( t=12.260, P<0.001). Comparison of the HAMD score, SDS total score and the factor scores, and Q-LES-Q-SF total scores of the MDD patients at different time points showed significant differences, presenting an F value of 65.987, 28.944, 23.589, 27.070 and 28.668, respectively (all P<0.001). HAMD 0 was negatively correlated with age. The HAMD score was positively correlated with SDS score of the same time point and negatively correlated with Q-LES-Q-SF score of the same time point. At 3 m, the change in HAMD score (HAMD 3 m-0) was positively correlated with the change in SDS score (SDS 3 m-0) and negatively correlated with the change in Q-LES-Q-SF score (Q-LES-Q 3 m-0). At 12 m, the change in HAMD score (HAMD 12 m-0) was positively correlated with the change in SDS score (SDS 12 m-0) and negatively correlated with the change in Q-LES-Q-SF score (Q-LES-Q 12 m-0). Regression analysis revealed that SDS 0 and Q-LES-Q 0 could be used to predict SDS 3 m-0, R 2=0.391, while SDS 0 and full-time employment status could be used to predict SDS 12 m-0, R 2=0.640. Q-LES-Q 0 could be used to predict Q-LES-Q 3 m-0, R 2=0.294, while Q-LES-Q 0 and full-time employment status could be used to predict Q-LES-Q 12 m-0, R 2=0.591. Conclusion: Long-term regular medication can improve social dysfunction in patients with MDD and symptom relief is the basis for improvement of social function level and quality of life, while increasing employment saturability to some extent may help improve the long-term social function and quality of life.

[A Review of Research Progress in the Pathophysiological Mechanism of Stress-related Mental Disorders].

Stress can improve an individual's ability to adapt to environmental changes. However, excessive stress can induce stress-related mental disorders, including anxiety disorder, depression disorder and post-traumatic stress disorder (PTSD). Stress can regulate the level of hormones and immune inflammation in the body through the brain network, neural circuits, hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, thereby causing the occurrence of mental disorders. In addition, stress can mediate the occurrence of mental disorders by regulating molecular changes in the level of genes, transcription, protein and metabolism, etc. Studies have shown that the brain-gut axis also plays an important role in the pathogenesis of stress-related mental disorders. However, the pathophysiological mechanism of stress-related mental disorders remains unclear. Besides, studies have also shown that the onset of stress-related mental disorders is closely associated with the individual's physiological and psychological qualities,which has a cross-talk with other mental and physical diseases as well. Therefore, it is important to study individual premorbid diathesis clinical, and to conduct clinical medical, basic medical, and psychological studies of the different stages of the disease, so as to obtain further understanding of the pathogenesis of stress-related mental disorders.

[Study on the Developmental Trajectory of Posttraumatic Stress Disorder Symptoms among Children and Adolescents].

OBJECTIVE: To investigate the heterogeneity of the developmental trajectory of posttraumatic stress disorder symptoms (PTS) among children and adolescents after Lushan earthquake and to explore the effect of gender and age on the trajectory. METHODS: A total of 1 623 participants completed three assessments at 2 weeks, 3 months and 6 months after the earthquake. Latent growth mixture model (LGMM) was used for statistical analysis in the software Mplus 8.0. RESULTS: The PTS developmental trajectories among children and adolescents exposed to the earthquake had four categories: the normal stress group (31.1%, class 1), the persistent impairment group (4.5%, class 2), the psychological recovery group (46.8%, class 3) and the persistent mild symptom group (17.6%, class 4). The PTS development trajectories were significantly different in two gender groups, and the proportion of girls in the persistently injured group was higher than other three groups. The PTS development trajectories had no difference in two age groups. CONCLUSION: The developmental trajectories of PTS in children and adolescents after the earthquake have significant population heterogeneity, which is affected by gender.

[Effects of Group Cognitive Behavioral Therapy on Social Anxiety Disorders].

OBJECTIVE: To evaluate the effect of group cognitive behavioral therapy (GCBT) on social anxiety disorders (SAD). METHODS: A total of 50 patients with SAD were recruited in this study. A survey containing the Liebowitz social anxiety scale (LSAS),the automatic thoughts questionnaire (ATQ),the fear of negative evaluation questionnaire (FNE),the social support rating scale (SSRS),the tridimensional personality questionnaire (TPQ),and the egna minnen barndoms uppfostran (EMBU) was administered before and (one week) after the GCBT,including in the 50 healthy controls. About 21 patients completed the eight-week GCBT (once a week,2 h a session). Follow-up surveys were conducted on 40 patients (22 patients treated with GCBT and 18 untreated) over a 1-5 year period. RESULTS: Significant differences were found between the SAD patients and healthy controls in thinking mode,personality characteristics,social support,parental rearing styles,and social anxiety symptoms. Significant decrease in social anxiety symptom ( t=4.06, P=0.000) , negative automatic thoughts ( t=4.58, P=0.000) and fear for rejection ( t=3.85, P=0.000) were observed after the GCBT therapy. Such improvement was positively correlated with subjective social support (r=0.361, P=0.022) ,and negatively correlated with rejection of father (r=-0.431, P=0.005) . There was also statistical difference between the patients with and without the GCBT therapy ( P=0.033) . CONCLUSION: GCBT treatment can relieve SAD symptoms by changing the negative cognitive of SAD patients. Social support and rejection of father affects the prognosis of SAD.

Percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue for advanced pancreatic carcinoma: Case Report.

RATIONALE: The aim of this study was to determine the effectiveness of intratumoral injection of chemotherapeutics in improving the quality of life and survival of patients with pancreatic carcinoma. PATIENT CONCERNS: We present a case series of 5 patients with unresectable pancreatic adenocarcinoma. DIAGNOSES: Patients diagnosed with unresectable poorly differentiated pancreatic ductal adenocarcinoma by intraoperative frozen biopsyor percutaneous biopsy. INTERVENTIONS: Five patients with unresectable pancreatic adenocarcinoma received a computed tomography-guided percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue. OUTCOMES: Mean overall survival was 16.2 ±â€Š3.7 months. Local control rates were 100% and 80% at postoperative 3 and 6 months, respectively. Mean Visual Analogue Scale pain score decreased from 7.2 ±â€Š.84 preoperatively to 2 ±â€Š1.22 at postoperative 4 weeks. There were no complications associated with the procedure. LESSONS: Percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue for advanced pancreatic may be safe and effective.

Transarterial Ethanol Ablation Combined with Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus.

BACKGROUND: The prognosis for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is extremely poor. OBJECTIVES: This study aimed to evaluate the safety and effectiveness of transarterial ethanol ablation (TEA) for the treatment of HCC with PVTT. METHODS: Patients were treated with TEA for PVTT under cone-beam computed tomography and traditional transarterial chemoembolization (TACE) with epirubicin for intrahepatic lesions. RESULTS: Seventeen men were successfully treated with TACE plus TEA. The mean overall survival was 18.3 ± 9.0 months (95% CI: 13.7 - 3.0 months). The quality of life (QoL) score increased from 56.9 ± 15.7 before the procedure to 88.5 ± 11.7 at 4 weeks after the procedure. Lipiodol accumulation grades of 3, 2, 1, and 0 were obtained in 3 (17.6%), 8 (47.1%), 6 (35.3%), and 0 (0%) patients, respectively. CONCLUSIONS: TEA is a safe and effective method for treating patients with PVTT, offering advantages for QoL, response rate after TEA, and OS.

[Regional Homogeneity Changes in Patients with Social Anxiety Disorders after Cognitive Behavioral Therapy.]

OBJECTIVES: To examine the altered spontaneous brain activity in patients with social anxiety disorders (SAD) before and after cognitive behavior therapy (CBT),and determine the neuromechanism of formation,treatment and recovery of SAD. METHODS: Fifteen SAD patients were treated with an eight-week group CBT.The patients underwent functional magnetic resonance imaging (fMRI) at resting state before and after the treatments.Eighteen healthy controls (HC) were recruited and underwent a baseline fMRI scan.The regional homogeneity (ReHo) of the patients was compared with the healthy controls.Before the baseline scanning,all participants were assessed with the Liebowitz Social Anxiety Scale(LSAS),the Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD). RESULTS: All participants were right-handed.10 males and 4 females were in the patient group,with mean age of (27.07±8.11) years.13 males and 5 females were in the HC group,with mean age of (26.28±2.42) years.There was no difference for gender and age while significant differences were found in LSAS,HAMA,HAMD between patients and controls (P<0.01).After 8 weeks of group CBT,clinical assessments significantly decreased (P<0.05) in patients group.Compared with HC,the pre-treatment SAD patients showed significantly increased ReHo in right cerebellum lobe at baseline [(P<0.05,with Gaussian random field (GRF) correction]; but the difference became insignificant after the group CBT.The post-treatment patients showed increased ReHo in left putamen and right caudate compared with their pre-treatment conditions (P<0.05,with GRF correction).Pre-post ReHo change in right cerebellum posterior in patients was positively correlated with pre-post change of LSAS-fear scores (r=0.62,P=0.015). CONCLUSIONS: The activity of cerebellum might be one of the potential biomakers to modulate the treatment effect of CBT in SAD,which provides a basis for further investigation into the pathophysiology of SAD.