目的 探讨nesfatin-1与2型糖尿病共病抑郁症的相关性.方法 选取2型糖尿病(T2DM)患者77例,根据抑郁症诊断标准分为T2DM共病抑郁症组25例(DDM组)、T2DM非抑郁症组52例(NDDM组);以年龄、性别相匹配的30例健康体检者为正常对照组(NC组).用汉密尔顿抑郁量表(HAMD)测量,并检测血浆nesfatin-1、空腹血糖(FPG)、血脂、空腹胰岛素(FINS)等水平.比较三组nesfatin-1水平变化,分析其与HAMD分数及其他指标的相关性.结果 DDM组nesfatin-1水平明显高于NDDM组及NC组(P＜0.01).T2DM患者(77例)nesfatin-1水平与HAMD分数、C肽、甘油三酯(TG)呈显著正相关(P＜0.05).回归分析示HAMD分数、TG和低密度脂蛋白-胆固醇(LDL-C)是影响nesfatin-1水平的独立相关因素(P＜0.05);nesfatin-1与DDM密切相关(OR=1.140,P＜0.01).结论 共病抑郁症的T2DM患者血浆nesfatin-1水平较非抑郁症组显著升高,其与T2DM患者的抑郁程度相关,其改变可能在DDM发生发展中发挥一定作用.

对Nesfatin-1参与抑郁症发病机制相关研究进展进行综述。

随着媒体和美容整形业的快速发展,人们的审美标准逐渐提高,对样貌更加关注,躯体变形障碍的患者也逐渐增加.由于此病的治疗困难,有些患者反复进行整形手术,但症状并未改善甚至加重,给患者造成了极大的痛苦.本文报告了3例典型躯体变形障碍病例,并对其治疗过程加以分析讨论.

Objective:To evaluate the efficacy of cognitive behavioral therapy ( CBT ) combined with pharmacotherapy in the treatment of panic disorder ( PD ) .Methods:The randomized controlled trials (RCTs)comparing the efficacy of cognitive behavioral therapy (CBT)combined with pharmacotherapy in the treatment of panic disorder ( PD) were systematically evaluated .The statistical analysis soft ware Rev-Man 5.2 was used to Meta-analysis.Results:Six studies were involved in the Meta -analysis,including 329 patients with PD .There were 6 sets of data which compared the total efficiency and significant effi-ciency of combined therapy and pharmacotherapy alone ,combined therapy were superior to pharmacother-apy alone in both total efficiency ( OR=3 .28 ,Z=2 .75 ,P<0 .05 ) and significant efficiency ( OR=2 .85 , Z=3.90,P<0.05).There were 5 sets of data which compared the cure rate of combined therapy and pharmacotherapy alone ,and combined therapy was superior to pharmacotherapy alone in cure rate ( OR=2.08,Z=2.82,P<0.05).Conclusion:It suggests that CBT combined with pharmacotherapy may be su-perior to pharmacotherapy alone in improving panic symptom and further study is necessary .

Objective:To explore plasma Nesfatin_1 level in gastric cancer patients with or without de_pression,and its relationship with the degree of depression? Method:The sixteen gastric cancer patients with depression( GCD group),18 gastric cancer patients without depression( GCND group)and 26 healthy controls ( NC group)were assessed with self depression scale( SDS)and Hamilton depression scale( HAMD)?Wihle plasma Nesfatin_1 and cortisol levels were detected?The correlation among those levels and the degrees of de_pression were analyzed? Results:The level of plasma Nesfatin_1 in GCD group was significantly lower than GCND group(P<0?05),and both of the two groups were significantly lower than NC group(all P<0?01)?The levels of plasma cortisol in GCD group were significantly higher than GCND group(P<0?001),but which in GCND group was significantly lower than NC group( P<0?01 )? The plasam Nesfatin_1 levels in GCD was negatively correlated with SDS score(r= —0?601,P=0?014)and HAMD score(r= —0?528,P=0?035);while there was no correlation with plasam cortisol level(r= —0?109,P=0?687)? Conclusion:Plasma Nes_fatin_1 level in gastric cancer patients with depression is significantly reduced?It may be related to the pathogen_esis and severity of depression in gastric cancer patients with depression.

Objective To investigate the clinical efficacy and safety of mirtazapine and sertraline in the treatment of patients of depression with anxiety. Methods 96 patients of depression with anxiety in our hospital were divided into two groups according to different treatment method, each group had 48 cases.The control group were received sertraline treatment, while the observation group were received mirtazapine treatment.The therapeutic effect of two groups were observed. Results There was no significant difference in antidepressant treatment effect between two groups(P>0.05).The anxiolytic treatment effect of the observation group was better than that of the control group,and the difference was statistically significant(P < 0.05). The decreased level of Hamilton Anxiety Scale score and Depression Scale score after a week of treatment in the observation group were better than those in the control group,and the difference was statistically significant(P < 0.05).There was no significant difference in incidence of adverse reactions between two groups(P > 0.05). Conclusion The effect of mirtazapine in the treatment of depressive is equivalent to sertraline,but its anxiolytic effect is better than that of the control group,and it has more rapid onset,tolerated adverse reactions,and is worthy of clinical promotion and application.

目的:对临床心理科门诊失眠患者心理状况进行相关性临床对比研究。方法:将70例研究对象分为两组,其中失眠患者(35例)作为观察组,睡眠正常者(35例)作为对照组,应用90项症状清单(SCL-90)对两组进行评价,然后对两组结果进行比较与分析。结果:观察组SCL-90各因子分均高于对照组,多数因子差异具有统计学意义(P<0.05)。结论:临床心理科门诊失眠患者较睡眠正常者更易出现焦虑、抑郁、敌对、恐怖、强迫症状、精神病性等症状。

选取78例患有抑郁症的患者，随机分为对照组和治疗组各39例。对照组采用舍曲林治疗；治疗组采用文拉法辛缓释剂治疗。结果治疗组患者疗效明显优于对照组；控制时间和实际用药治疗时间明显短于对照组。应用文拉法辛缓释剂对患有抑郁症的患者实施治疗的临床效果非常明显。