Objective:To explore the correlation between depression and comorbidity of cerebral small vessel disease（CSVD） in patients with depression, so as to provide evidence for early prevention and treatment.Methods:Totally 80 patients with stable depressive episode and recurrent depressive disorder according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision（ICD-10）,as well as 97 normal controls were included.Medical historywas collected, and cognitive function and mental status were assessedusing Montreal Cognitive Assessment（MoCA）,Mini-Mental State Examination（MMSE）,Hamilton Depression Scale and Hamilton Anxiety Scale.Positive rate of CSVD diagnosis and the relevant magnetic resonance imaging（MRI） diagnostic features were evaluated by cranial MRI.Logistic regression analysis was used to analyze the correlation between depression and CSVD.Results:The age of depression group and normal control group were（59±9） years and（58±8） years, respectively（P＞0.05）.Higher proportion of hypertension and lower MoCA total scores were seen in the depression group than in the normal control group（Ps＜0.05）.The proportion of CSVD was higher in the depression group than in the normal control group（83.8% vs.64.9%,P＜0.01）.Logistic regression analysis showed that lacunar cerebral infarction（OR=4.4,95%CI:1.07-18.23）,frontal lobe demyelination（OR=2.4,95%CI:1.05-5.42） and MoCA＜26（OR=2.3,95%CI:1.16-4.47） were the risk factors of depression.Conclusion:Comorbid CSVD is common in the middle-aged and elderly patients with depression, for whom lacunar cerebral infarction and frontal lobe demyelination maybe the risk factors.

BackgroundThe highly heterogeneous pathogenesis of depression and limited response to current antidepressants call for more objective evidence for depression subtypes. Reactive and endogenous depression are two etiologically distinct subtypes associated with different treatment responses. This study aims to explore the potential biomarkers that differentiate reactive and endogenous depressions.MethodsThe clinical manifestations and biological indicators of 64 unmedicated mild-to-moderate depression patients (32 reactive depression patients and 32 endogenous depression patients) and 21 healthy subjects were observed. The 24-item Hamilton rating scale for depression (HAMD-24) was used to evaluate the severity of depression. Serum levels of depression-related biological indicators were measured by using the enzyme-linked immunosorbent assay.ResultsThe NLRP3 level of reactive depression was significantly lower than those of endogenous depression and healthy controls. There was a significant negative correlation between the BDNF level and the HAMD-24 total scores for patients with reactive depression.ConclusionOur findings suggested the serum NLRP3 and BDNF levels could be potential biomarkers for detecting and evaluating the severity of reactive depression.

谵妄又称为急性脑病综合征,是一种可逆性的认知障碍综合征,主要表现为注意力无法集中和认知功能障碍[1-2].谵妄在临床很常见,其发生率可达20％-40％,重症患者则更是高达35％～80％[3-5].谵妄不仅会导致机械通气时间及住院时间延长、病死率增加、医疗费用增加及照顾者负担加重等短期影响,亦会对患者的活动能力和认知功能造成长期的损害[6-12].

一些孩子,一般是初中、高中的学生进入青春期后,因为某种原因,突出表现就是爆发出情绪的不稳定. 常见的诱因有:学习困难,学习成绩下降,考试失利,自己又不能接受.交友困难,比如行为模式不被同伴接受,或者谈恋爱失败.可能在受到同学欺负或者老师批评后出现.

Objective:To investigate whether facial expression recognition correct rates were changed in stable patients with major depressive disorder.Methods:A cross-sectional study was performed in patients with major depressive disorder (n=80) (according to the DSM-IV) and matched normal controls by age, gender and education year (n=41) in this study.All subjects would recognize five different expression (anger, contempt, fear, happiness and sadness).These emotions were displayed on four different male and female computerized cartoon faces, and each expression was shown once in a static format and once in a dynamic format.The facial expression recognition correct percentage would be compared between the two groups.Results:The correct identification rate of contempt was lower in the patients than in the normal controls (93％ vs.94％, P＜0.05).The correct identification rate of dynamic contempt was lower in the patients than in the normal controls (93％ vs.95％, P＜0.05).The correct identification rate of fear was lower in the patients than in the normal controls (89％ vs.93％, P＜0.05).The correct identification rate of dynamic fear was lower in the patients than in the normal controls (90％ vs.94％, P＜0.05).Regarding error rates of misattribution, compared with normal controls, depressive patients over-identified fear to anger (3.7％vs.1.8％) and contempt (2.9％vs.0.9％), sadness to contempt (5.0％ vs.1.7％) and happiness (2.0％ vs.0.2％) (Ps＜0.05).Conclusion:Patients with MDD have significantly great difficulties identifying negative expressions.

Objective:To compare the cognitive functions in patients with depressive disorder,hyperlipidemia disorder,and comorbid both of the disorders.Methods:A cross-sectional study was performed in age,gender and education year matched patients with depressive disorder (n =51)(according to the ICD-10),hypedipidemia(n =38) (according to the Chinese adult lipid guideline),comorbid both of the disorders(n =40) and normal controls (n =56) were recruited in this study.All subjects received a battery of neuropsychological tests to access the anxiety and depression symptoms and cognitive function.Results:The scores of MoCA were lower in the patients with comorbid both disorders and patients with depression than patients with hypedipidemia [(24 ± 3),(24 ± 4)vs.(26 ± 3),Ps ＜0.05],and were lower in patients with depression than in normal controls(25 ±3),P ＜0.05.Stroop color test amends numbers were higher in patients with comorbid disorder than in the other three groups (Ps ＜0.05).The scores of immediate and delayed logical memory were higher in patients with hyperlipidemia than in other three groups (Ps ＜0.05).The total number of words in verbal fluency test were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia (Ps ＜0.05).Wisconsin card sorting test category completes were lower in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜ 0.05).The scores of persistent errors were higher in patients with comorbid disorders and patients with depression than in patients with hyperlipidemia and normal controls (Ps ＜0.05).Conclusion:In this study,patients with depressive disorder have impairment of cognitive function,while hyperlipidemia may probably do not impair cognitive function.

目的 比较病情稳定的抑郁症和精神分裂症患者认知功能的差异.方法 选取40例抑郁症患者,44例精神分裂症患者和41例正常对照.采用汉密尔顿抑郁量表(HAMD),阳性和阴性症状评估量表(PANSS)评估临床严重程度,重复性成套神经心理状态测验(RBANS)评估认知功能.结果 抑郁症患者在注意力因子评分显著低于正常;精神分裂症即刻记忆、视觉广度、注意力和延时记忆的评分都显著低于正常对照,延时记忆的评分也低于抑郁症患者.在线条定位、词汇回忆评分也显著低于抑郁症患者.进一步做相关分析显示,抑郁症患者数字广度测验(评价注意力)与抑郁症的严重程度呈负相关性.精神分裂症患者注意力总分与PANSS总分、一般精神病理得分、阳性症状评分和阴性症状评分与呈负相关性,症状越重,注意力评分越差.另外RBANS总分与PANSS总分和阳性症状总分也呈负相关性.结论 抑郁症和精神分裂症患者都存在认知功能的损害,并且与症状严重度呈相关性,其中精神分裂症患者损害更重.

The onset of obsessive-compulsive disorder (OCD) involves the interaction of heritability and environment. The aim of this study is to identify the global messenger RNA (mRNA) expressed in peripheral blood from 30 patients with OCD and 30 paired healthy controls. We generated whole-genome gene expression profiles of peripheral blood mononuclear cells (PBMCs) from all the subjects using microarrays. The expression of the top 10 mRNAs was verified by real-time quantitative PCR (qRT-PCR) analysis. We also performed an enrichment analysis of the gene ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) annotations of the differentially expressed mRNAs. We identified 51 mRNAs that were significantly differentially expressed between the subjects with OCD and the controls (fold change ≥1.5; false discovery rate <0.05); 45 mRNAs were down-regulated and 6 mRNAs were up-regulated. The qRT-PCR analysis of 10 selected genes showed that they were all up-regulated, which was opposite to the results obtained from the microarrays. The GO and KEGG enrichment analysis showed that ribosomal pathway was the most enriched pathway among the differentially expressed mRNAs. Our findings support the idea that altered genome expression profiles may underlie the development of OCD.

急性呼吸困难是常见的急诊患者就诊原因,重度呼吸困难是重症监护的原因之一.呼吸困难可以是精神心理疾病的症状,和焦虑、惊恐发作高度相关;也可以是躯体疾病伴随的焦虑表现,两者相互影响、恶性循环,积极的抗焦虑治疗可以缓解躯体疾病所致的呼吸困难.对呼吸困难的病因做出准确的诊断,防止误诊漏诊,采取有效的治疗措施,可缓解患者病痛,救助生命.

Objective To explore the differences of prodromal symptoms between bipolar disorder (BD) and recurrent major depressive disorder (RMDD).Methods We used the Bipolar Prodrome Symptom Interview and Scale-Retrospective to investigate 74 BD patients and 37 RMDD patients,which included open questions and semi-structured questions about the 39 prodromal symptoms to the first full depressive episode.Results (1) Most of BD patients (91.9％,68/74) and RMDD patients (97.3％,36/37) could recognize their prodromal symptoms.(2) BD patients reported more psychotic symptoms than RMDD patients (t=-3.761,P=0.001).(3) Compared with RMDD patients,more BD patients reported prodromal symptoms,overly cheerful/happy/on top of the world(16 cases (21.6％,16/74) vs.2 cases (5.4％,2/37),x2=5.269,P=0.022),overly talkative (19 cases (25.7％,19/74) vs.3 cases (8.1％,3/37),x2=5.370,P=0.020),racing thoughts or jumping from one thought to another (17 cases (23.0％,17/74) vs.3 cases (8.1％,3/37),x2=4.168,P=0.041),extremely energetic or active (18 cases (24.3％,18/74) vs.1 cases (2.7％,1/37),x2=8.777,P=0.003),overly self confident (14 cases (18.9％,17/74)vs.0,x2=8.514,P=0.002),and frequent mood swings/lability (38 cases (51.4％,38/74) vs.8 cases (24.3％,8/37),x2=10.537,P=0.001),and these symptoms were more likely to be a part of the bipolar prodromal symptoms.Conclusions BD patients and RMDD patients represent different prodromal symptoms,which could promote early identification and early intervention of BD.

Dopamine signaling is strongly implicated in the etiology of schizophrenia (SZ). Because of the essential role dopamine D2 receptor (DRD2) in dopamine signaling, DRD2 gene has been regarded as one of the top candidate genes for SZ. However, the findings from linkage and association analyses on this gene are mixed and largely inconsistent across various studies. The aim of this study is to investigate the correlation of DRD2 gene variation and the risk for SZ in a Chinese Han population. Three SNPs (rs1801028, rs6275 and rs6277) of DRD2 gene were genotyped in a patient–control sample involving 421 SZ patients and 404 healthy controls. Our data indicated a nominally significant association of rs6277 with SZ, with T-allele being the risk allele (OR = 1.58, 95%CI = 1.03–2.43, P = 0.034). This study suggests that rs6277 T-allele may play a role in the genetic vulnerability for SZ, supporting the involvement of DRD2 gene in SZ pathogenesis.

Alteration of neuroendocrine systems has been demonstrated to be involved in the pathology of posttraumatic stress disorder (PTSD). Three months after an earthquake in Northern China, cortisol, growth hormone (GH) and prolactin (PRL) levels were assessed in 34 earthquake survivors with PTSD (according to DSM-IV criteria), 30 earthquake survivors with subclinical PTSD and 34 normal controls. Only earthquake survivors diagnosed with PTSD had significantly higher serum GH levels. Also, we found that earthquake survivors (either with PTSD or subclinical PTSD) had significantly higher serum cortisol levels. We concluded that PTSD might be associated with an increased level of serum GH and traumatic survivors might be associated with a higher level of serum cortisol.

Background: Electroacupuncture (EA) has been used to treat Major Depressive Disorder (MDD). However, its efficacy is inconclusive and the mechanism is still unclear. Thus, the objective of this study is to investigate the therapeutic effect of EA on GTP-binding-protein (G protein) in platelet membrane using fluoxetine as a comparison.Methods: A randomized controlled trial (RCT) was performed on 90 MDD patients, who were divided into three groups treated with fluoxetine, EA and sham EA respectively. Antibodies were utilized to quantify the levels of G protein alpha subtypes in the platelet membrane before and after 6-week anti-depressive treatment. Thirty age and sex-matched normal individuals were used as controls.Result: All the treatments had the same therapeutic effects in treating moderate depression. Both levels of G alpha i and G alpha q in depression patients were significantly higher than those in controls and were not reduced by treatments, although the severity was considerably relieved.Limitations: The duration of treatment was limited to six weeks only.Conclusion: EA might be served as an alternative treatment for moderate depression and we further demonstrate that the abnormal levels of Get protein in platelet membrane might be a potential risk factor for MDD. (c) 2006 Elsevier B.V. All rights reserved.

OBJECTIVE:It is evident that immune cytokines are involved in the pathophysiology of posttraumatic stress disorder (PTSD), but results of different studies are still inconsistent. Here, serum interleukin (IL)-2, IL-6 and IL-8 levels were compared between earthquake survivors with PTSD, those with non-PTSD and normal controls to investigate whether there is any relationship between cytokine levels and PTSD. In addition, the relationship of these cytokines with psychological parameters of the disorder was examined as well.METHODS:Thirty-four earthquake survivors with PTSD (according to DSM-IV criteria), 30 earthquake survivors with non-PTSD and 34 controls were recruited in northern China using the Composite International Diagnostic Interview instrument. Serum IL-2, IL-6 and IL-8 levels were compared. IL-2 levels were measured by radioimmunometric assay, while serum IL-6 and IL-8 levels were measured using sandwich enzyme-linked immunosorbent assay. Psychological symptoms were assessed using 3 subscales of the Symptoms Checklist (SCL-90-R), including depression, anxiety and somatization.RESULTS:Only earthquake survivors diagnosed with PTSD had significantly lower serum IL-8 levels. Also, we found that earthquake survivors (either with PTSD or non-PTSD) had significantly lower serum IL-2 levels and more severe psychological symptoms. The severity of depressive and anxiety symptoms in earthquake survivors was positively related to serum IL-6 levels.CONCLUSIONS:PTSD may be associated with a reduced level of serum IL-8, and traumatic survivors may be associated with a lower level of serum IL-2.

Objective To study plasma cortisol, growth hormone, prolactin and interleukin concentration changes in patients with post-traumatic stress disorder (PTSD) and stress disorders.Methods An earthquake took place in Zhang Bei and Shang Yi, Hebei Province in January 10~th 1998. Three months later, we used radio-immunity technique to test plasma cortisol, growth hormone and prolactin and Interleukine-2 (IL-2) concentrations, and Elisa technique to test plasma Interleukine-6 (IL-6), Interleukine-8 (IL-8) concentrations in 34 trauma survivors with PTSD (diagnosed according to Diagnostic and Statistical Mannal of Mental Disorders IV criteria), 30 trauma survivors without PTSD and 34 normal controls in Zhang Bei, Shang Yi.Results Plasma concentrations in survivors with PTSD and those without PTSD were all significantly higher than that in normal controls (P=0.013, P=0.006). Plasma IL-2 concentrations in trauma survivors with PTSD and trauma survivors without PTSD were all significantly lower in comparison to normal controls (P=0.000,P=0.000). Plasma prolactin hormone and IL-6 concentrations were not significantly different among the three groups (P=0.389,P=0.363). Plasma growth hormone concentration in trauma survivors with PTSD was not different from that in trauma survivors without PTSD (P=0.099), and normal control (P=0.014), but significantly higher in trauma survivors without PTSD than in normal controls (P=0.014). Plasma IL-8 concentration in trauma survivors with PTSD was significantly higher than in trauma survivors without PTSD (P=0.021), but not different from normal control (P=0.078), and significantly lower in trauma survivors without PTSD than in normal control (P=0.000).Conclusion It is indicted that the neuroendocrine and immunology systems in PTSD and stress disorder are abnormally changed.

阿尔茨海默柄(Alzheimer' s Disease AD),旧称老年痴呆,是引起老年期痴呆的主要原因,死亡率高,严重威胁着老年人的健康.病理特征是一种进行性的脑神经退行性变.临床表现为进行性高级皮层功能紊乱和智力、认知功能的损害.AD在老年人中平均发病率为4.2%,并随年龄的增加而增高,60岁组的患病率为2.3%,70岁组的患病率为3.9%,80岁组的患病率为32%[1].随着我国日渐进入老龄化社会,AD病人的数目在不断增加,所以对AD的早期发现和诊治是减少国民负担的一个有效措施.然而AD起病隐袭,发病机制不明,目前的治疗仅仅是对证治疗和可能的对因治疗,因此从AD的发病机制上寻找AD的对因治疗是当务之急.

Objective To test whether the polymorphisms of cholecystokinin A (CCK A) receptor gene were related to schizophrenia in schizophrenic family Methods The alleles and genotypes of CCK A receptor gene were examined with polymerase chain reaction restriction fragment length polymorphism in 90 schizophrenic families The probands met with the tenth revision of International Classification of Diseases and Related Health Problems criteria for schizophrenia and were assessed with the Positive and Negative Symptoms Scale (PANSS) Results (1) Transmission disequilibrium test (TDT) showed there were no significant transmission disequilibrium in both patients and their non affected siblings (χ 2=0 69 and 0 71; P 0 05) (2) When female and male patients were studied separately, there were significantly different negative symptoms scores between genotypes of CCK A receptor gene In the rank sum test, the total score of PANSS negative factor in female patients with genotype of A1A2 was significantly higher than those with A2A2 ( P =0 000) The score of first two negative factors in male patients with genotype of A1A2 was significantly lower than those with A2A2 ( P =0 01) Conclusions The CCK A receptor gene may be not as the functional gene of schizophrenia, but may influence the severity of negative symptom of the disease

细胞代谢、生长、增殖、癌变的调控与生物信息分子如激素、神经递质、细胞 (生长)因子、癌蛋白及某些药物等所携带的生物信息在细胞内的传递密切相关.细胞内信号转导通路系统是一个错综复杂的网络系统,对这一系统的认识,可使我们了解抑郁症的发病机制、抗抑郁药的作用位点,为新药物的研制提供思路.