Clinical symptoms and their relationship with cognitive impairment in elderly patients with depressive disorder.

Objective: To evaluate the correlation between clinical symptoms and cognitive impairment in elderly patients with depressive disorder. Methods: In this retrospective study, a total of 123 elderly patients with depressive disorder admitted to our hospital from January 2020 to February 2021 were included. Patients' cognitive function was assessed by the Montreal Cognitive Assessment Scale (MoCA). According to the combination of cognitive impairment or not, patients were divided into the combined group (64 cases) and the depressive disorder group (59 cases). In addition, 70 healthy people who came to our hospital for physical examination during the same period were randomly selected as the healthy group. Results: The incidence of severe cognitive impairment in the combined group (33, 51.56%) was significantly higher than that in the depression group (19, 32.20%), the difference was statistically significant (P = 0.003). The incidence of somatization symptoms, suicidal tendency, retardation of thinking, diminution of energy, anxiety and sleep disorder in the combined group were higher than that in the depressive disorder group with significant difference [30 (56.88%) vs. 16 (27.12%), P = 0.024; 12 (18.75%) vs. 3 (5.08%), P = 0.021; 33 (51.56%) vs. 14 (23.73%), P = 0.002; 37 (57.81%) vs. 23 (38.98%), P = 0.029; 42 (65.63) vs. 25 (42.37), P = 0.011; 50 (78.13) vs. 42 (71.19), P = 0.031, respectively]. Spearman rank correlation analysis suggested that somatic symptom, mood change, suicidal tendency, retardation of thinking, diminution of energy, anxiety, and sleep disorder were negatively correlated with cognitive impairment, respectively (r =-0.161, -0.672, -0.262, -0.871, -0.421, -0.571, -0.512, P < 0.001). Conclusion: The clinical symptoms of depressive disorder were negatively correlated with cognitive impairment. Somatic symptoms, suicidal tendency, retardation of thinking, diminution of energy, anxiety, and sleep disorder were the risk factors for cognitive impairment.

The Clinical Effect of Blue Light Therapy on Patients with Delayed Sleep-Wake Phase Disorder.

OBJECTIVE: To investigate the feasibility and patient acceptance of applying blue light glasses to treat delayed sleep-wake phase disorder (DSWPD). METHODS: Fifteen patients with DSWPD were collected as the observation group and 15 healthy people as the control group. The patients wore blue light glasses with a continuous radiation wavelength of about 470 nm for 1h to 2h during the period from 06:30 to 09:00 in the morning after waking up, respectively. Assessment of Hamilton Anxiety Scale 14 items (HAMA14), Hamilton Depression Rating Scale 24 items (HAMD24), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Morningness-Eveningness Questionnaire (MEQ), and Insomnia Severity Index (ISI) scores before and after 1 week of treatment. Pearson correlation was used to analyze the correlation between the efficacy of patients with sleep-wake phase delay disorder and HAMA14, HAMD24, PSQI, ISI, ESS, MEQ, SL (sleep time), TST (total sleep time), TTiB (total time in bed), SQ (sleep quality), TOA (total arousal time), WASO (wake after sleep onset), AAT (average arousal time), and SE (sleep efficiency percent). Multi-factor logistic regression analysis of factors influencing the efficacy of patients with sleep-wake phase delay disorder. RESULTS: After treatment, PSQI-G scores, number of nighttime awakenings and time of awakening recorded in the sleep diary decreased significantly in the observation group (P < 0.05), and subjective sleep quality and MEQ scores increased (P < 0.05). MEQ score shifted from "moderate night type" to "intermediate type", sleep-wake phase tended to shift forward. The total PSQI score and Pittsburgh Sleep Quality Index Global (PSQI-G) score were significantly lower in the control group after treatment (P < 0.05). By Pearson correlation analysis, the efficacy of patients with sleep-wake phase delay disorder was significantly correlated with HAMA14, HAMD24, PSQI, ISI, ESS, MEQ, SL, TST, TTiB, SQ, TOA, WASO, AAT, and SE. Multifactorial logistic regression analysis revealed that the factors influencing the efficacy of patients with sleep-wake phase delay disorder were PSQI, ISI, ESS, MEQ, SL, TST, TTiB, SQ, TOA, WASO, AAT, and SE. CONCLUSION: Blue light therapy has a positive effect on improving subjective sleep quality, reducing the number of nocturnal awakenings and the duration of nocturnal awakenings, improving daytime function, and shifting the sleep phase forward in patients with DSWPD. Blue light therapy improves subjective sleep quality and daytime function the following day in normal individuals.

Therapeutic effects of human umbilical cord mesenchymal stem cells transplantation on hypoxic ischemic encephalopathy.

OBJECTIVE: Human umbilical cord mesenchymal stem cells (hUC-MSCs) hold substantial promise for the treatment of ischemic neurological disease, but few clinical data are currently available about its therapeutic effects in hypoxic ischemic encephalopathy (HIE). This study is to evaluate the effects of hUC-MSCs transplantation on patients with HIE. Methods A total 22 patients with HIEwere randomly divided into hUC-MSCs transplantation group (n = 12) and control group (n = 10). After isolation, hUC-MSCs were cultured for 3 to 5 passages in vitro and then intravenously administered to HIE patients in the transplantation group, while the control group received routine treatment only. The outcomes of HIE patients were evaluated at designated time points by clinical assessment scales, including NIHSS, Barthel Index, MMSE, HAMA24, HAMD14 and UPDRS. RESULTS: hUC-MSCs were identified by morphological analysis and flow cytometry assays before clinic transplantation. No significant differences of demographic characteristics were observed between the two groups of subjects. Compared to the control group, hUC-MSCs transplantation markedly improved the outcomes of HIE patients leading to better recovery of neurological function, cognition ability, emotional reaction and extrapyramidal function. No significant adverse effects were found in subjects with hUC-MSCs transplantation during a 180-day follow-up period. CONCLUSION: These data suggest that hUC-MSCs therapy markedly improves the outcomes of patients with HIE, which is potential for the routine treatment of ischemic neurological disease.