BACKGROUND:Mood disorders are important clinical manifestations of vascular depression (VaDep). We explored the efficacy of escitalopram plus tandospirone citrate in treating VaDep and the involvement of blood neurotransmitters during the treatment. METHODS:This single-center, double blind, randomized controlled study randomly divided patients with VaDep into Monotherapy group (escitalopram + placebo) or Combined group (escitalopram + tandospirone citrate). The primary outcome measures were the changes in psychological assessment scales from baseline to week 12, including the Hamilton Anxiety Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Patient Health Questionnaire-15 (PHQ-15), Somatic Symptom Scale (SSS). RESULTS:Compared with the Monotherapy group, the Combined group reported a significant decrease in the HAMD score at post-treatment week 2 (95 % CI 3.97 to 5.85, p < 0.001), in the PHQ-15 score at post-treatment weeks12 (95 % CI 0.54 to 1.37, p < 0.001), and increased in platelet 5-HT1AR at post-treatment weeks 12 (95 % CI 0.08 to 0.29, p < 0.0001). In both groups, the level of platelet 5-HT1BR was significantly lower at post-treatment week 12 than before the treatment (p < 0.001). The mediation analysis showed that tandospirone ameliorated somatization symptoms by alleviating depression, with platelet 5-HT1BR playing a regulatory role by alleviating depression (β = 0.28; 95 % CI: 0.25 to 0.31). CONCLUSION:Combination treatment significantly improves anxiety, depression, and somatization symptoms in patients with VaDep in which platelet 5-HT1AR and platelet 5-HT1BR are potential objective indicators. These findings may provide clinical insights for the treatment of VaDep.

BackgroundTo investigate the efficacy and underlying mechanisms of a combined therapy of estradiol/dydrogesterone and escitalopram in treating perimenopausal anxiety and depression.MethodsA total of 195 patients were randomized to receive escitalopram, estradiol/dydrogesterone, or combination therapy for 12 weeks. The primary efficacy endpoints were the changes in scores of the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) at week 12 compared with the baseline.ResultsCompared with the baseline, all groups reported a gradual decrease in Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Patient Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HAMD, and HAMA scores (P<0.001 for all), and a gradual increase in serum estradiol (E2) and 5-Hydroxytryptamine (5-HT) (P<0.001 for both), with the most pronounced changes in the Combined group (Comb group). In intergroup comparison, at weeks 4, 8, 12, the scores of PHQ-15, GAD-7, PHQ-9, HAMA, and HAMD were most reduced in the Comb group; At weeks 2, 4, 8, 12, E2 level was significantly higher in the Comb group and estradiol/dydrogesterone group (E/D group) than in the escitalopram group (ESC group); at weeks 4, 8, and 12, 5-HT level was significantly higher in the Comb group than in the E/D group; and at week 4 and 12, 5-HT level was significantly higher in the Comb group than in the ESC group.ConclusionsEstradiol/dydrogesterone plus escitalopram significantly improves anxiety, depression, and somatic symptoms in perimenopausal women. These findings provide clinical evidence of estradiol/dydrogesterone plus escitalopram regimen for the treatment of patients with perimenopausal anxiety and depression.

AIMS:To explore the efficacy of Femoston plus escitalopram for perimenopausal women with chronic insomnia and the relevant biomarkers. METHODS:A total of 166 patients randomly received: escitalopram plus placebo (Escitalopram Group), Femoston plus placebo (Hormone Group), and Femoston plus escitalopram (Combined Group) for 3 months and followed for 2, 4, 8, and 12 weeks. The primary efficacy endpoint was changes in Pittsburgh Sleep Quality Index Scale (PSQI), Insomnia Severity Index Scale (ISI), and Epworth Sleepiness Scale (ESS) scores at week 12 from baseline. Secondary endpoints included changes in the Modified Kupperman Menopausal Index Scale (KMI) scores, blood 5-HT neurotransmitters and their receptor, and blood sex hormone levels during the treatment. RESULTS:Compared with baseline levels, all groups displayed increased serum 5-HT levels and decreased serum FSH levels, with more significant changes in the combined group. Compared with the other two groups, the combined group reported a gradual increase in serum E2 levels and a gradual decrease in serum LH levels, and the lowest KMI, ESS, ISI, and PSQI scores at weeks 4 and 12. The PSQI score was negatively correlated with serum 5-HT and E2 and positively correlated with serum FSH and LH levels, respectively. CONCLUSION:Femoston plus escitalopram improves chronic insomnia in perimenopausal women. Serum levels of 5-HT, E2, FSH, and LH may objectively indicate the clinical severity of chronic insomnia in this population.

Chronic sleeplessness is a primary clinical symptom of vascular depression (VaDep). We investigated the efficacy and safety of escitalopram plus tandospirone citrate for patients with VaDep and chronic insomnia and the potential correlation of insomnia severity with neurotransmitter indexes, including serotonin (5-HT), serotonin 2C receptor (5-HT2CR), serotonin 7 receptor (5-HT7R) in platelets, and plasma 5-HT. This double-blind, randomized controlled study randomized patients with VaDep and chronic insomnia [Hamilton depression rating scale (HAMD) > 17 points] into a monotherapy group [escitalopram (10 mg once daily) plus placebo] or combined group [escitalopram (10 mg once daily) plus tandospirone citrate (10 mg three times daily)] by using a 1:1 assignment algorithm generated by SPSS 25.0 software. The primary endpoint was the change in sleep quality from baseline to week 12, evaluated by the Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG), Epworth Sleepiness Scale, and Asen Self-Rating Insomnia Scale (AIS). Secondary outcomes were the changes in depression and anxiety assessment and the levels of peripheral blood neurotransmitters from baseline to week 12, including HAMD, the Hamilton anxiety scale (HAMA), 5-HT, 5-HT2CR, 5-HT7R in platelets, and plasma 5-HT. The levels of 5-HT, 5-HT2CR, and 5-HT7R were detected with the enzyme-linked immunosorbent assay kits. The safety assessment included the Treatment-Emergent Symptom Scale and clinical and laboratory variables. The therapeutic improvement was analyzed by a generalized estimation equation. A total of 123 subjects (30.89

AIMS:To explore the pharmacological treatment of vascular depression (VaDep) and whether the blood levels of neurotransmitters can reflect the VaDep severity. METHODS:VaDep patients with somatic symptoms were enrolled and randomly received venlafaxine + tandospirone (Combined Group) or venlafaxine (Monotherapy Group). The treatment efficacy was assessed by Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Patient Health Questionnaire-15 (PHQ-15). The levels of blood monoamine neurotransmitters were measured by enzyme-linked immunosorbent assay. RESULTS:Both groups reported a progressive decrease in HAMD, HAMA, and PHQ-15 scores to below the baseline after the respective treatment. Compared with the Monotherapy Group, the Combined Group reported a significant decrease in HAMD score at week 2 and markedly lower HAMA and PHQ-15 scores at weeks 1, 2, 4, and 8. Both groups showed a decrease in the levels of blood monoamine neurotransmitters at weeks 4 and 8 when compared with the baseline. A strong positive association was evident between the plasma 5-HT levels and the HAMD score. CONCLUSION:The combined therapy rapidly acts on VaDep comorbid with anxiety and somatic symptoms and significantly alleviates the anxiety and somatic symptoms. The plasma levels of 5-HT may serve as potential objective candidates in evaluating VaDep severity and the efficacy of the undertaken treatment regimen.

目的 总结特发性快速眼动睡眠期行为障碍(iRBD)患者认知功能特点和睡眠结构,并探讨二者之间的相关性.方法 共纳入2018年8月至2021年8月就诊于福建医科大学附属协和医院的73例iRBD患者,均进行神经心理学测验和多导睡眠图监测,采用Pearson相关分析和偏相关分析探讨认知功能与睡眠结构参数的相关性.结果 (1)神经心理学测验:iRBD患者简易智能状态检查量表(MMSE)评分(t=-3.703,P=0.000)、蒙特利尔认知评价量表(MoCA)评分(t=-4.811,P=0.000)、词语流畅性测验(VFT)-词汇正确个数(t=-2.171,P=0.032)低于对照者,连线测验(TMT)-A(t=2.500,P=0.014)、TMT-B(t=2.430,P=0.016)和 Stroop 色词测验(SCWT)-A(t=2.507,P=0.013)、SCWT-B(t=15.042,P=0.000)、SCWT-C(t=27.228,P=0.000)完成时间长于对照者.(2)多导睡眠图监测:iRBD患者总睡眠时间(t=2.699,P=0.008)、睡眠效率(Z=-2.103,P=0.035)、睡眠分期转换次数(t=3.965,P=0.000)、非快速眼动睡眠期1期(N1期)占总睡眠时间比例(t=2.887,P=0.005)、睡眠期周期性肢体运动指数(PLMSI;t=-2.917,P=0.004)、周期性肢体运动相关微觉醒指数(Z=-2.291,P=0.022)、微觉醒总指数(Z=-2.609,P=0.009)高于对照者,入睡后清醒时间短于对照者(t=-2.230,P=0.027).(3)认知功能与睡眠结构参数相关性:MoCA评分与N1期占比呈负相关(r=-0.184,P=0.035),与N2期占比呈正相关(r=0.173,P=0.049);SCWT-B完成时间与觉醒次数呈负相关(r=-0.186,P=0.033);SCWT-C完成时间与睡眠分期转换次数(r=0.212,P=0.015)和N1期占比(r=0.181,P=0.039)呈正相关;VFT-词汇正确个数与清醒期周期性肢体运动指数(PLMWI;r=-0.216,P=0.018)呈负相关;中文Rey听觉-词汇学习测验(C-RAVLT)即刻回忆正确个数与快速眼动睡眠期潜伏期呈正相关(r=0.183,P=0.045);C-RAVLT延迟回忆正确个数与PLMWI(r=-0.196,P=0.032)和PLMSI(r=-0.180,P=0.049)呈负相关;画钟测验评分与入睡潜伏期(r=0.192,P=0.035)和快速眼动睡眠期潜伏期(r=0.199,P=0.029)呈正相关,而与快速眼动睡眠期占比呈负相关(r=-0.189,P=0.038);Beck抑郁量表评分与总睡眠时间(r=0.347,P=0.000)、睡眠效率(r=0.319,P=0.000)、快速眼动睡眠期占比(r=0.204,P=0.026)呈正相关,而与入睡后清醒时间(r=-0.280,P=0.002)、N1期占比(r=-0.299,P=0.001)呈负相关.结论 iRBD患者存在以注意力、执行功能、语言功能下降为主要表现的认知功能障碍,而睡眠结构紊乱可能影响此类患者的认知功能.

Cognitive impairment is a prominent clinical manifestation of vascular depression (VaDep). The current study aimed to assess the efficacy of tandospirone citrate in VaDep cases with mild cognitive impairment (VaDep-MCI) as well as the role of plasma monoamine neurotransmitters during the treatment. In this single-blind, randomized controlled study, 116 participants were randomly assigned to the tandospirone (tandospirone citrate-escitalopram) and control (escitalopram) groups. The primary endpoints were changes in cognitive test scores from baseline to Week 8, including the Rey Auditory Verbal Learning Test (RAVLT), Semantic Verbal Fluency (SVF) test, Trail Making Test (TMT), Digital Span Test (DST) and Clock Drawing Test (CDT) scores. Generalized estimating equation models were used to examine repeated measures. The results showed that compared with the changes in the control group from baseline to Week 8, the tandospirone group showed more significant changes in SVF score at Weeks 4 (p < 0.05) and 8 (p < 0.001), and TMT (B-A) score at Week 8 (p < 0.05). RAVLT, DST and DCT scores were relatively stable in both groups during the study period. Moreover, mediation analysis showed that these results were not mediated by the alleviation of depression symptoms. Partial Spearman correlation analysis showed that only plasma 5-hydroxytryptamine (5-HT) was positively correlated with Hamilton Depression Rating Scale score after Bonferroni correction (r = 0.347, p < 0.001). Augmentation therapy with tandospirone citrate improved the executive and language functions of VaDep-MCI patients. Additionally, plasma 5-HT levels may serve as a potential biomarker of VaDep severity. These findings may provide clinical insights into the treatment of vascular depression.

BACKGROUND:Facial emotion perception and recognition (FEPR) deficits are the sources of disability, impaired social relationship, and reduced quality of life. Studies of unilateral acute ischemic stroke (AIS) remain controversial about FEPR deficits.METHODS:Clinical and neurocognitive data were collected and analyzed among normal controls (NC) and AIS patients with left brain damage (LBD), right brain damage (RBD), and infratentorial brain damage (IBD). To assess FEPR, all participants completed a localization test (the Southeastern China Brief Affect Recognition Test). Correlation analyses were conducted between the FEPR deficits and cognitive functions.RESULTS:Compared with NC, all three groups of AIS patients reported significant FEPR deficits. Although no statistical difference in FEPR deficits were observed among the LBD, RBD and IBD patients, the deficit patterns were markedly different. FEPR deficits were positively correlated with cognitive impairment.CONCLUSIONS:FEPR deficits may occur in AIS patients and are associated with impaired cognitive functions, where the cerebral hemispheres and the infratentorial brain are jointly involved. Early recognition and early intervention of FEPR deficits in AIS patients are critical for post-stroke rehabilitation, reconstruction of social function and improvement in life quality.

目的 探讨特发性快动眼睡眠行为障碍(iRBD)患者在多项睡眠监测下(PSG)睡眠结构和快速眼动期肌肉失弛缓(RSWA)严重程度及特点.方法 选取2018年8月至2021年8月就诊于福建医科大学附属协和医院神经内科的iRBD患者共156例(iRBD组)以及同期来体检的健康人群101例(对照组),所有人行PSG监测.分析iRBD组和对照组受检者睡眠结构特点和RSWA参数结果,并对两者进行相关性分析.结果 iRBD组睡眠结构紊乱,片段化,慢波睡眠减少,周期性肢体运动(PLM)相关指数增高.iRBD患者RSWA现象明显,但男女亚组分析发现两组的下颌时相性肌张力增高指数、下颌紧张性肌张力增高指数无明显差异.下颌时相性肌张力增高指数与睡眠效率呈负相关.结论 iRBD患者睡眠结构明显异常,男女患者RSWA严重程度相当,睡眠效率是iRBD患者RSWA严重程度的影响因素,提高iRBD患者的睡眠效率有助于降低iRBD患者的RSWA严重程度.

目的 探讨老年性抑郁患者发生卒中的危险因素.方法 采用病例对照研究,收集笔者医院2009-2019年老年性抑郁患者1000例的病例资料.根据患者是否发生卒中,分为卒中组和非卒中组.收集两组患者的一般信息、生活习惯、合并疾病等情况,探讨老年性抑郁患者的卒中特点.采用多因素Logistic回归分析筛选老年性抑郁患者卒中的影响因素.结果 高血压病(OR=1.049,95％ CI:1.015～2.075)、糖尿病(OR=1.338,95％ CI:1.003～1.568)、无配偶(OR=2.721,95％ CI:1.063～4.527)、小学及以下受教育程度(OR=4.600,95％ CI:1.711～5.517)、家庭年收入水平≤5.0万元(OR=3.529,95％ CI:1.161～6.233)是老年性抑郁患者发生卒中的独立危险因素.结论 患高血压病及糖尿病、无配偶、文化程度低、家庭年收入水平低的老年性抑郁患者卒中风险增加.

Vascular depression can respond poorly to antidepressants. This study aimed to explore the efficacy and safety of tandospirone plus escitalopram for treating vascular depression with anxiety. This pilot randomized controlled trial included consecutive inpatients/outpatients with vascular depression/anxiety at the Department of Neurology, Fujian Medical University Union Hospital, China (January 2014 to December 2016). Among 157 patients screened, 100 were randomly divided into the tandospirone + escitalopram (combination therapy) and escitalopram (monotherapy) groups equally, and then followed for 8 weeks. Efficacy was evaluated using the Hamilton Depression (HAMD), Hamilton Anxiety (HAMA), Clinical Global Impression (CGI) and Mini-Mental State examination (MMSE) scales. Adverse events (AEs) were assessed with the Treatment Emergent Symptom Scale (TESS). HAMD and HAMA scores decreased progressively, showing reductions versus baseline at 1, 2, 4 and 8 weeks in both groups (P < 0.001). HAMD and HAMA scores were lower in the tandospirone + escitalopram group than those in the escitalopram group at 1 and 2 weeks (P < 0.001), but not at 4 and 8 weeks. Improvements in CGI scores (severity, improvement and efficacy indexes) were greater in the tandospirone + escitalopram group than that in the escitalopram group at 1 and 2 weeks (P < 0.01), but not at 4 and 8 weeks. The tandospirone + escitalopram group had higher MMSE scores than that in the escitalopram group at 4 and 8 weeks (P < 0.01). All AEs were mild, and the rates were comparable between groups. Augmentation of escitalopram with tandospirone accelerates the onset of anti-depressive and anxiolytic effects and improves cognitive function in patients with vascular depression and anxiety.

As a classic immunoregulatory cytokine, interleukin-10 (IL-10) can provide in vivo and in vitro neuroprotection respectively during cerebral ischemia and after the oxygen-glucose deprivation (OGD)-induced injury. However, its role in cortical neuronal survival at different post-ischemic phases remains unclear. The current study found that IL-10 had distinct effects on the neuronal apoptosis at different OGD stages: at an early stage after OGD, IL-10 promoted the OGD-induced neuronal apoptosis in the cultured primary cortical neurons by activating p65 subunit, which up-regulated Bax expression and down-regulated Bcl-xL expression; at a late OGD stage, however, it attenuated the OGD-induced neuronal apoptosis by activating c-Rel, which up-regulated Bcl-xL expression and down-regulated Bax expression. The early-stage pro-apoptosis and late-stage anti-apoptosis were both partly abolished by PDTC, an NF-κB inhibitor, and promoted by PMA, an NF-κB activator. The optimal anti-apoptotic effect appeared when the cultured neurons were treated with IL-10 at 9-24 h after OGD. Taken together, our findings suggest that IL-10 exerts a dual effect on the survival of the cultured neurons by activating the NF-κB pathway at different stages after OGD injury and that PMA treatment at a late stage can facilitate the IL-10-conferred neuroprotection against OGD-induced neuronal injury.

目的 在大脑中动脉狭窄/闭塞的高血压脑梗死患者中,探讨血压成分与基底节区扩大的血管周围间隙之间的相关性.方法 回顾性纳入自2014年1月到2018年12月在福建医科大学附属协和医院经临床、颅脑计算机断层扫描血管造影(CTA)及头颅核磁共振成像(MRI)确诊为大脑中动脉狭窄/闭塞的高血压脑梗死患者49例,根据脑小血管病评估量表对患者头颅MRI上基底节区扩大的血管周围间隙(BG-EPVS)进行评估,将患者分为＞10BG-EPVS和≤10 BG-EPVS组,比较两组患者年龄、性别、收缩压、舒张压、脉压、平均动脉压(MAP)及其他血管相关因素等基线特征.采用Logistic回归分析法,评估血压成分与＞10 BG-EPVS之间的相关性.采用受试者工作特征曲线(ROC曲线)分析法计算收缩压、舒张压、脉压和MAP判断＞10 BG-EPVS的曲线下面积(AUC).结果 自2014年1月到2018年12月,共纳入49例符合入选标准的大脑中动脉狭窄/闭塞的高血压脑梗死患者[年龄(65.1±10.5)岁,男性30例(61.2％)].与≤10 BG-EPVS组患者比较,＞10 BG-EPVS组患者年龄更大[(67.7±8.1)比(60.4±12.7)岁],收缩压[(146.5±12.7)比(137.7±13.2) mm Hg]和MAP[(103.2±9.4)比(97.5±9.6)mm Hg,均P＜0.05]更高.Logistic回归分析显示,在调整年龄因素后,收缩压(OR=1.08,95％ CI 1.01～1.15,P=0.025)和MAP(OR=1.19,95％ CI 1.06～1.34,P=0.003)与＞10 BG-EPVS存在显著相关性.ROC曲线分析显示:收缩压和MAP的AUC分别为0.711(95％ CI 0.551～0.870,P=0.015)和0.710(95％ CI 0.553～0.867,P=0.015);舒张压和脉压的AUC分别为0.629(95％ CI 0.463～0.795,P=0.135)和0.575(95％ CI 0.391～0.759,P=0.384).结论 在大脑中动脉狭窄/闭塞的高血压脑梗死患者中,收缩压和MAP与＞10BG-EPVS存在显著相关性,是判断＞10 BG-EPVS的良好指标,可视为＞10 BG-EPVS的标志物.

Objectives? To assess the impact of childhood trauma on cognitive function in healthy young adults. Methods? Three times since February 2012, the Childhood Trauma Questionnaire (CTQ) was used to screen out healthy young people with childhood trauma and without any form of childhood trauma. These participants were then evaluated using the Wisconsin Card Sorting Test (WCST), the Stroop Test, Trail Making Test, Verbal Fluency Test, and the Wechs Memory Scale (WMS). Results? The performance of young adults with childhood trauma (n=90) was significantly different in the Verbal Fluency Test, the visual regenerative test of WMS and WCST compared with those with no childhood trauma (n=104). The total score of CTQ was negatively correlated with results of Visual Reproduction and Trail Making Test B, while it was positively correlated with results of WCST ervor response; the number of different types of childhood trauma was negatively correlated with the Stroop test, number of WCST correct response and partial results and partial results of WMS (all P＜0.05). Conclusions? The cognitive function of healthy young people with childhood trauma is impaired. The more severe the trauma in childhood or the higher the number of different traumas, the worse is their cognitive function.

Background: To investigate the sleep status of patients with vascular depression (VD) and analyze the characteristics of sleep by polysomnogram. Methods: 50 VD patients, 30 patients with non-vascular depression (NVD) and 50 normal subjects were enrolled. All subjects were evaluated by the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), Pittsburgh Sleep Quality Index (PSQI) and Epworth sleepiness scale (ESS). All these patients were monitored by polysomnography (PSG). Results: The PSQI scores of the VD patients didn't show difference compared with that of NVD, but both of them were significantly higher than the normal. The ESS scores of VD patients were significantly higher than other groups. The total sleep time (TST), sleep efficiency (SE) and sleep maintenance (SMT) in NVD patients and VD patients were poorer, and the waking time after sleep onset (WASO) and sleep latency (SL) were significantly longer. The N1/N2 ratio was longer, and the N3/REM ratio was shorter in NVD patients and VD patients. The HAMD score was negatively correlated with RL and positively with RD, RA and RI. The RL of VD patients was longer than the normal, and RD and RI were higher in VD patients, there was no difference in RA. The obstructivity and apnea-hypopnea index (AHI) significantly increased in VD patients. Conclusion: The characteristic PSG findings of the NVD patients were shortening REM sleep latency and REM disinhibition. Characteristics of VD with PSG patients were sleep-related breathing disorders (SRBD) and daytime sleepiness, and disorders of 24-h sleep structure. Copyright (C) 2018, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC.

目的 探讨头痛宁胶囊治疗紧张性头痛的可能作用机制. 方法 将80只SD大鼠随机分为模型组、对照组及头痛宁高、中、低剂量组,每组16只.采用颈部肌肉注射三磷酸腺苷诱发紧张性头痛.头痛宁高、中、低剂量组分别给予头痛宁胶囊悬液(760、380、190 mg/kg),模型组、对照组给予等量生理盐水,各组均连续灌胃7天.观察大鼠给药前后张颌反射的阈值及潜伏期,并检测脑组织及血清中一氧化氮合酶(NOS)、5-羟色胺(5-HT)及谷氨酸含量.结果 头痛宁各剂量组给药后张颌反射潜伏期明显延长(P＜0.05),且随头痛宁剂量增加改善更加显著(P＜0.05).与模型组比较,头痛宁各剂量组张颌反射阈值均明显升高(P＜0.05),各剂量组之间差异无统计学意义(P＞0.05).头痛宁各剂量组较模型组血浆中NOS活性、5-HT含量明显下降,谷氨酸含量升高(P＜0.05),且随药物剂量增加,各指标改善均更加显著(P＜0.05). 结论 头痛宁胶囊可通过影响头区肌肉和皮肤的张颌反射阈值,改变头区肌筋膜痛敏感性来影响紧张性头痛的发作,其机制可能与下调NOS活性,降低5-HT和上调谷氨酸含量有关.

Objective To study the clinical effects and safety of Huperzine A and Escitalopram in treatment of vascular dementia(Va D).Methods 108 patients with Va D were randomly divided into Huperzine A therapy group,Escitalopram therapy group and combination of Huperzine A and Escitalopram therapy group(each had 36 patients).Patients in each groups were given general drugs,and patients in Huperzine A therapy group were treated with Huperzine A(0.2g/d),patients in Escitalopram therapy group were treated with Escitalopram(10mg/d),,the group treated with Huperzine A and Escitalopram were treated with Huperzine A(0.2g/d) and Escitalopram(10mg/d).Before and 12 weeks after treatment,the mini mental status examination(MMSE),activity of daily living(ADL,using Barthel Index) and P300 potentials were measured by the same doctor.Results After 12 weeks of treatment,The cognitive function and behavioral abilities were improved in each group,and the effect of latency shorten and amplitude elevate of P300 potentials in each group,specially in the group treated with Huperzine A and Escitalopram.Conclusion Combination of Huperzine A and Escitalopram can markedly ameliorate the cognitive function and behavioral abilities in patients of Va D,and was well tolerated and safe.

Objective To investigate the effect of venlafaxine on learning and memory ability in rats with vascular dementia(VD).Methods Totally 90 Wistar rats were divided into sham-operation group,model group and treatment group (n=30 for each).The VD rat model was established by modified pulsinellis 4-vessel occlusion (4 VO).Rats in the sham-operation group and model group were administered with gastric perfusion of distilled water.Rats in the treatment group were administrated with gastric perfusion of Venlafaxine at 15 mg/kg per day for 4 weeks from the 2nd day after the modeling.The one-way avoidance test was performed to study the learning-memory ability of each group.The contents of norepinephrine,5-hydroxytryptamine and BDNF in the hippocampus and cortex of rats were observed.Results Model group demonstrated a decrease in the percentage of one-way avoidance test (50.3±6.2 vs.92.3±5.6,P＜0.01) as compared with sham-operation group,and this value was increased in treatment group (62 2±4.6).Compared with the sham-operation group,the contents of NE and 5-HT in the hippocampus [(226±34) pg/g and (340±40) pg/g],and cortex [(601±66) pg/g and (657±43) pg/g] in rat brains of model group were decreased (P＜0.01),while increased in treatment group [(264±45) pg/g and (379±42)pg/g,(665±68) pg/g and (798±51)pg/g,P＜0.05].The OD value of BDNF in the hippocampus (0.495±0.041) and cortex (0.488±0.042) were increased (P＜0.05) in model group,and in treatment group,BDNF levels were more higher (0.579±0.044 and 0.578±0.06/4,P＜0.05).Conclusions The content of brain monoamine neurotransmitters are decreased in rats with VD,while venlafaxine can improve the learning memory ability in model rats through increasing the levels of 5-HT,NE and BDNF in hippocampus and cortex.

AIM:To investigate the effects of adipose-derived stem cells (ADSCs) transplantation on neuronal apoptosis in the brain after focal cerebral ischemia in rats.METHODS:72 male adult Sprague-Dawley rats were randomly divided into 4 groups: Sham-operated group , Middle cerebral artery occlusion (MCAO) group, Vehicle group and ADSC-treated group (n=18). MCAO model was established with the modified Longa's method. One day after right MCAO, 30 μL of cell suspension containing 1×10(6); cells were injected into the lateral ventricle of ADSC-treated group and the same dose of PBS was given to the vehicle group. At 4 d, 7 d and 14 d after MCAO, the apoptosis of neuron was detected by terminal deoxynucleotidyl transferase-mediated DNA nick-end labeling (TUNEL) method and the expression of Bcl-2 and caspase-12 in ischemic region was detected by immunohistochemistry and RT-PCR.RESULTS:TUNEL-positive cells in ischemic region of ADSC-treated group were less than that in MCAO group and Vehicle group at 4 d, 7 d and 14 d post MCAO (P<0.05). Compared with MCAO group and Vehicle group, the expression of Bcl-2 significantly up-regulated while caspase-12 expression significantly decreased in ADSC-treated group at any time point post MCAO (P<0.05).CONCLUSION:The transplantation of ADSCs can reduce neuronal apoptosis of rats with cerebral ischemic injury partly by promoting the expression of Bcl-2 which participates in apoptotic signals after mitochondrial damage and inhibiting the expression of caspase-12 which mediates endoplasmic reticulum (ER) stress-induced apoptosis.