Background: The use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), has been linked to adverse effects on bone health, but findings are conflicting. This study aimed to quantify the associations between newer antidepressants and bone mineral density (BMD) and fracture risk through a comprehensive meta-analysis. Methods: Observational studies on the association between the use of novel antidepressants and BMD and hip fracture were systematically searched in PubMed, Embase, CINAHL, Cochrane Library, and Scopus. Random effects meta-analyses were conducted to pool results across the eligible studies. The heterogeneity, publication bias, and influence were assessed extensively. Results: 14 eligible studies with 1,417,134 participants were identified. Antidepressant use was associated with significantly lower BMD compared to non-use at all skeletal sites examined, with pooled standardized mean differences (SMD) ranging from –0.02 (total hip) to –0.04 (femoral neck). Importantly, antidepressant use was associated with a 2.5-fold increased risk of hip fracture (pooled odds ratio (OR) 2.50, 95% CI 2.26–2.76). While heterogeneity was detected, the overall findings were robust in sensitivity analyses. Conclusions: This meta-analysis provided strong evidence that novel antidepressants, especially widely used SSRIs, have detrimental impacts on bone health. The observed associations with decreased BMD and doubled hip fracture risk have important clinical implications.

In this study, mRNA expression of gastric cancer tissue and clinical data of patients in TCGA-STAD dataset were used, together with the hypoxia-related gene sets in the MsigDB database, to screen hypoxia-related differentially expressed genes (DEGs) in GC. Thereafter, univariate and multivariate Cox regression analyses were carried out on hypoxia-related DEGs. The optimal feature genes related to prognosis were obtained to construct a prognostic risk assessment model. According to the model, the riskScore of GC patients was measured, and GC samples were assigned into high- and low-risk groups in accordance with the median riskScore. Based on the Kaplan-Meier curve and Receiver operating characteristic curve, validity of the prognostic risk assessment model was measured. Gene set enrichment analysis was performed on the two risk groups through Gene set enrichment analysis software. The results revealed that in the high-risk group, 9 signaling pathways were remarkably activated in several terms, like focal adhesion, extracellular matrix receptor interaction, Cell adhesion molecules cams, Cytokine-cytokine receptor interaction, TGF-beta signaling pathway, NOD-like receptor signaling pathway, JAK-STAT signaling pathway, Toll-like receptor signaling pathway and MAPK signaling pathway. In combination with riskScore and clinical factors, univariate and multivariate Cox regression analyses verified the independence of the model. Meanwhile, a nomogram was constructed to predict the 1-, 3- and 5-year survival of GC patients. The calibration curve indicated that the survival status predicted by the nomogram fitted better with actual survival status. On the whole, the prognostic risk model of GC on the basis of hypoxia-related genes demonstrated good predictive ability. It can provide more powerful technical support for clinicians to make prognostic determination and therapeutic plans.

目的 分析帕金森病患者肠道菌群的变化及与临床特征的相关性.方法 选择2017年11月至2019年2月温州市人民医院神经内科诊治的帕金森病患者(PD组)和同期健康体检者(HC组),各30例.对PD组进行统一帕金森病评分量表第三部分(UPDRSⅢ)、Hoehn&Yahr分级量表(H-Y分级)、简易精神状态检查量表(MMSE)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、帕金森病自主神经症状量表(SCOPA-AUT)、Wexner便秘评分等评估.采集两组对象血液、粪便样本,通过16S-rDNA测序确定微生物种类并进行微生物分类分析,利用生物信息学方法对比PD组和HC组之间的差异菌群,并对PD组患者菌群丰度和临床特征进行相关性分析.结果 PD组和HC组菌群多样性比较,差异无统计学意义(P>0.05).PD组患者粪便中门水平疣微菌门、黏胶球形菌、异常球菌的丰度高于HC组,属水平毛螺旋菌属、链球菌属、克雷伯菌属、伯劳特菌属丰度低于HC组,埃希菌属、瘤胃球菌属、巨单胞菌属、阿克曼菌属、巨型球菌属、颤杆菌属、伯克菌属、埃森博格拉菌属、异味杆菌属、丹毒丝菌科未命名属、脱硫弧菌属、普雷沃菌属、单胞菌属、脱硫弧菌科未命名属、嗜胨菌属丰度高于HC组,差异均有统计学意义(均P<0.05).UPDRSⅢ与脱硫弧菌呈正相关(rho=0.482,P<0.05).HAMA、HAMD与巨型球菌属呈正相关(rho=0.524、0.429,P<0.05).SCOPA-AUT与普雷沃菌属呈负相关(rho=-0.558,P<0.05).MMSE与埃森博格拉菌属呈负相关(rho=-0.547,P<0.05).结论 PD组和HC组的菌群结构在门、属水平上均有明显的差异.PD组患者肠道菌群中条件致病菌的增多及短链脂肪酸产生菌减少.帕金森病菌群变化与临床特征有一定相关性.

目的:探究美多巴与普拉克索治疗帕金森病的效果和对生活质量及尿酸水平的影响.方法:选择2018年5月～2020年4月到某院将治疗帕金病的患者作为本研究的观察对象,病例样本为74例,随机将患者分为单一组与联合组各37例.单一组患者予以美多巴进行治疗,联合组患者在单一组的给药基础上添加普拉克索进行药物联合治疗,对比两组患者的临床疗效与尿酸水平变化,再使用生活质量量表(SF-36)评估患者生活质量.结果:治疗后,联合组患者生活质量量表评分中的社会关系、心理状况、生理状况、独立性、环境评分均优于单一组患者,其差距具统计学意义(P<0.05);联合组治疗总有效率优于单一组(94.59％>78.38％),其差距具统计学意义.治疗前两组患者尿酸水平比较,无明显差异;在治疗后单一组尿酸水平为(286.64±35.58)μmo1/L,联合组患者尿酸水平为(342.47±29.82)μmo1/L,组间差距较为显著,具统计学意义(P<0.05).结论:美多巴与普拉克索治疗帕金森病,可取得较为显著的疗效,并有效提高患者的生活质量.