布拉酵母联合小剂量红霉素 治疗小儿功能性消化不良的临床观察

目的探讨布拉酵母联合小剂量红霉素治疗小儿功能性消化不良(FD)的临床疗效。方法将92例FD患者随机分为对照组(n=46)和观察组(n=46)。对照组单纯用红霉素3～5mg/(kg·d),3次/d饭前服用。观察组在对照组治疗方法基础上联合布拉酵母0.25g/次,2次/d,餐后口服,2周一疗程。随访6个月观察其复发率。结果观察组总有效率(95.65%)明显高于对照组(76.09%),差异有统计学意义(P0.01)。2组患者治疗后HAMD评分均较治疗前下降,但观察组降低幅度显著大于对照组(P0.01)。观察组患者症状消失时间显著短于对照组,差异有统计学意义(P0.01)。治疗后随访6个月,观察组患者复发率明显低于对照组(P0.05)。结论布拉酵母联合小剂量红霉素对小儿FD具有显著的临床疗效,患者的复发率较低。     

布拉氏酵母菌联合维生素D对产后抑郁症干预的研究

目的探讨布拉氏酵母菌联合维生素D治疗产后抑郁症的临床效果。方法选择我院收治的产后抑郁症患者102例,随机分为观察组和对照组各51例。两组患者均给予心理干预,对照组予维生素D800IU/次,1次/d口服,观察组在对照组基础上联合布拉氏酵母菌0.5g/次,2次/d口服,4周一疗程。观察两组患者临床疗效及心里干预效果。结果观察组患者治愈率及总有效率均高于对照组,两组比较差异有统计学意义(P<0.01,P<0.05)。治疗前两组患者HAMD评分及1,25(OH)_2D_3水平比较,差异无统计学意义(P>0.05)。治疗后两组患者HAMD评分均较治疗前下降,1,25(OH)_2D_3水平比治疗前升高,但观察组降、升幅度明显大于对照组(P<0.01)。结论布拉氏酵母菌联合维生素D干预产后抑郁症具有明显的临床疗效。     

布拉酵母联合美沙拉嗪对溃疡性结肠炎患者氧化应激的 影响及疗效观察

目的探讨布拉酵母联合美沙拉嗪对溃疡性结肠炎(UC)患者氧化应激的影响及疗效。方法选取2016年7月至2017年12月我院内科门诊治疗的活动期UC患者76例,随机分为观察组和对照组。对照组患者予以美沙拉嗪肠溶片1.0g/次,4次/d,口服。观察组在对照组基础上加用布拉酵母0.5g/次,2次/d,连用8周。观察并比较两组患者治疗前后的血清一氧化氮(NO)、氧化低密度脂蛋白(ox-LDL)、谷胱甘肽过氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)水平的变化,并评估患者临床疗效和不良反应。结果治疗8周后,两组患者血清NO和ox-LDL水平较治疗前明显下降,GSH-Px和SOD水平较治疗前明显上升(P0.05或P0.01),且观察组下降或上升幅度较对照组更大(P0.05)。观察组患者临床总有效率为94.74%,明显高于对照组的78.95%(χ~2=4.15,P0.05)。对照组和观察组患者不良反应发生率分别为10.53%(4/38)和15.79%(6/38),症状均较轻,两组比较差异无统计学意义(χ~2=0.46,P0.05)。结论布拉酵母联合美沙拉嗪肠溶片治疗UC患者的效果确切,安全性较高,其作用机制可能与其能降低血清NO和ox-LDL水平,升高血清GSH-Px和SOD水平,减轻氧化应激对肠黏膜损伤密切相关。     

布拉酵母联合制霉菌素对 婴幼儿鹅口疮的疗效评价

目的探讨布拉酵母联合制霉菌素干预婴幼儿鹅口疮的临床疗效。方法将90例患儿随机分为对照组和观察组各45例。对照组患儿单用制霉菌素涂口腔,3次/d。观察组在对照组基础上联用布拉酵母0.125g/次,2次/d,口服,2周一疗程。结果观察组患儿痊愈率为66.67%,显著高于对照组的33.33%(χ2=10.00,P0.01)。观察组患儿总有效率为97.78%,显著高于对照组的73.33%(χ2=10.88,P0.01)。治疗后随访6个月观察组患儿总复发率显著低于对照组(χ2=14.01,P0.01)。结论布拉酵母联合制霉菌素对婴幼儿鹅口疮具有良好的临床疗效,患儿复发率低。     

布拉酵母联合奥替溴铵对 腹泻型肠易激综合征的疗效

目的探讨布拉酵母联合奥替溴铵对腹泻型肠易激综合征(IBS-D)的临床疗效。方法将80例IBS-D患者随机分为对照组和观察组各40例。对照组患者采用奥替溴铵40mg/次,3次/d,口服。观察组患者在对照组基础上联用布拉酵母0.5g/次,2次/d,饭前30min口服。4周为一疗程。结果治疗后观察组患者腹泻症状消失时间和用药总时间明显短于对照组(P0.05)。观察组患者临床总有效率(95.0%)高于对照组(67.5%),两组比较差异有统计学意义(P0.01)。观察组患者治疗后抑郁与焦虑评分明显低于对照组,差异有统计学意义(P0.01)。结论布拉酵母联合奥替溴铵对IBS-D患者临床疗效明显,可以迅速控制患者腹泻症状,减少患者用药不良反应。     

布拉酵母与培菲康对原发性高脂血症的临床疗效比较

目的比较布拉酵母与培菲康治疗原发性高脂血症(EHL)的临床疗效。方法将132例EHL患者采用随机数字表法分为对照组和观察组各66例。对照组患者口服培菲康2.0g/次,3次/d,饭后半小时温水服用;观察组患者口服布拉酵母1.0g/次,2次/d,8周为一疗程。比较两组患者治疗前后血脂水平及治疗效果。结果观察组患者临床显效率为59.69%,总有效率为93.94%。对照组患者临床显效率为46.96%,总有效率为77.27%,差异均有统计学意义(P0.05)。治疗后两组患者血脂水平均有改善,但观察组患者TG、TC、LDL-C水平显著低于对照组(P0.01),HDL-C显著高于对照组(P0.01)。治疗后随访6个月,对照组患者复发率为37.25%(19/51),观察组为8.06%(5/62),两组比较差异有统计学意义(P0.01)。结论布拉酵母对患者血脂的改善效果显著优于培菲康,患者复发率低,且无明显不良反应。     

硝呋太尔制霉素阴道软胶囊联合布拉酵母对 细菌性阴道病的疗效及安全性评价

目的探讨硝呋太尔制霉素阴道软胶囊联合布拉酵母对细菌性阴道病(BV)的临床疗效及安全性。方法将90例门诊收治的BV患者随机分为治疗组与对照组各45例,对照组患者采用硝呋太尔制霉素阴道软胶囊1粒(500mg),清洁外阴后放入阴道深部,每晚一次。观察组患者在对照组基础上联合布拉酵母0.5g/次,2次/d,口服,2周为一个疗程。比较两组患者临床疗效、复发率及不良反应发生率。结果观察组患者总有效率显著高于对照组(93.33%vs 77.77%),复发率显著低于对照组(60.00%vs 12.00),差异均有统计学意义(P0.05)。两组患者不良反应发生率差异无统计学意义(17.78%vs 15.56%,P0.05)。结论阴道内用药联合口服益生菌对BV患者的疗效优于单一阴道内给药,患者复发率低,安全性较高。     

认知疗法联合舍曲林治疗产后抑郁症患者的临床疗效研究*

摘要目的：探讨认知疗法合并舍曲林治疗产后抑郁症患者的临床疗效。方法：将本院2011 年10 月至2012 年7 月收治的76 例 产后抑郁症患者按随机数字表法分为认知疗法合并舍曲林治疗组(试验组,38 例)和舍曲林单独治疗组(对照组,38 例),进行临床 随机双盲对照试验,采用17 项汉密尔顿抑郁量表(Hamilton Depression Rating Scale,HAMD)、临床整体量表- 疗效总评估量表 (Clinical Global Impression,CGI) 评价和比较两组的临床疗效。结果：(1) 试验组的有效率显著高于对照组,差异有统计学意义 [92.11%vs 81.58 %),P<0.01],试验组第2、3 阶段的临床有效率均显著高于对照组,差异有统计学意义(P<0.05)。(2) 与治疗前相 比,两组患者治疗后的HAMD、CGI-SI 总分均降低,差异有统计学意义(P<0.01);治疗第1、2、3 阶段,试验组HAMD、CGI-SI 减分 值均显著高于对照组,差异有统计学意义(P<0.05)。结论：认知疗法联合舍曲林治疗产后抑郁症的短期治疗内疗效显著优于舍曲 林单独治疗。     

醋酸亮丙瑞林对子宫内膜异位症患者血清雌二醇、孕酮及黄体生成素水平的影响

目的:研究醋酸亮丙瑞林对子宫内膜异位症患者血清雌二醇、孕酮及黄体生成素水平的影响。方法:选取2016年10月至2017年9月我院收治的84例子宫内膜异位症患者,根据患者入院顺序分为观察组和对照组,每组42例。观察组使用醋酸亮丙瑞林治疗,对照组使用炔雌醇环丙孕酮片。比较两组患者的临床疗效,治疗前后痛经评分、血清雌二醇、孕酮、黄体生成素、TGF-β、IL-4、IL-10、IL-17水平的班花及不良反应的发生情况。结果:治疗后,观察组临床总有效率显著高于对照组[90.48%(38/42) vs.64.29%(27/42)](P0.05)。两组患者治疗后痛经评分、雌二醇、孕酮、黄体生成素、TGF-β、IL-4及IL-10水平均较治疗前显著降低(P0.05),且观察组以上指标均明显低于对照组(P0.05)。两组患者治疗后血清IL-17水平及不良反应发生率与治疗前相比均无明显差异(P0.05)。结论:与炔雌醇环丙孕酮片相比,醋酸亮丙瑞林能有效提高子宫内膜异位症患者的临床疗效,降低其血清雌二醇、孕酮及黄体生成素水平,改善患者的痛经情况,且安全性较高。     

甘麦大枣汤合归脾汤加减对PSD(心脾两虚证)的疗效及肠道菌群变化

目的探讨脑卒中后抑郁症(PSD)(心脾两虚证)患者接受甘麦大枣汤合归脾汤加减治疗的临床效果,并采用高通量测序检测其肠道菌群变化。方法选取本院收治的120例PSD(心脾两虚证)患者,随机分为对照组和观察组,各60例,对照组给予常规西医治疗,观察组在此基础上给予甘麦大枣汤合归脾汤加减治疗。比较两组患者治疗前后神经功能缺损评分(NIHSS)和抑郁评分、抗抑郁疗效、不良反应发生情况及肠道菌群丰度差异。结果治疗前两组患者NIHSS和HAMD评分比较,差异无统计学意义(P0.05),与治疗前相比,治疗后两组患者NIHSS和HAMD评分均降低(P0.001),观察组均低于对照组(P0.001)。比较两组患者抗抑郁疗效等级分布,差异具有统计学意义(Z=5.332,P=0.022),且观察组总有效率高于对照组(χ~2=6.000,P=0.014)。治疗前,观察组和对照组患者肠道菌群OTU数分别为653和658,独有个数分别为51和46,占各自OTU总数的7.81%和6.99%,差异无统计学意义(t=0.672,P=0.503),治疗后,观察组和对照组患者肠道菌群OTU数分别为498和552,独有个数分别为222和168,占各自OTU总数的44.58%和30.43%,与治疗前相比,两组患者肠道菌群OTU数目均降低(观察组:t=15.363,P0.001;对照组:t=9.456,P0.001),且观察组OTU数目低于对照组(t=9.084,P0.001)。对照组和观察组不良发应总发生率分别为11.67%、8.33%,差异无统计学意义(χ~2=0.370,P=0.054)。结论甘麦大枣汤和归脾汤加减能够更好地修复PSD(心脾两虚证)患者神经功能损伤,缓解患者抑郁症状,具有更好地抗抑郁效果,有助于改善患者肠道菌群,安全可靠,值得推广应用。     

Efficacy of light therapy for perinatal depression: a review

ABSTRACT: Perinatal depression is an important public health problem affecting 10-20% of childbearing women. Perinatal depression is associated with significant morbidity, and has enormous consequences for the well-being of the mother and child. Treatment of depression during the perinatal period poses a complex problem for both mother and clinician, as antidepressant treatment strategies must consider the welfare of both mother and child during pregnancy and lactation. Bright light therapy may be an attractive treatment for perinatal depression because it is low cost, home-based, and has a much lower side effect profile than pharmacotherapy. The antidepressant effects of bright light are well established, and there are several rationales for expecting that bright light might also be efficacious for perinatal depression. This review describes these rationales, summarizes the available evidence on the efficacy of bright light therapy for perinatal depression, and discusses future directions for investigation of bright light therapy as a treatment for perinatal depression.     

THE GENETIC INTERPRETATION OF INBREEDING DEPRESSION AND OUTBREEDING DEPRESSION

Inbreeding with close relatives and outbreeding with members of distant populations can both result in deleterious shifts in the means of fitness-related characters, most likely for very different reasons. Such processes often occur simultaneously and have important implications for the evolution of mating systems, dispersal strategies, and speciation. They are also relevant to the design of breeding strategies for captive populations of endangered species. A general expression is presented for the expected phenotype of an individual under the joint influence of inbreeding and crossbreeding. This expression is a simple function of the inbreeding coefficient, of source and hybridity indices of crossbreeding, and of specific forms of gene action. Application of the model may be of use in identifying the mechanistic bases for a number of evolutionary phenomena such as the shift from outbreeding enhancement to outbreeding depression that occurs with population divergence.     

Randomized controlled trials of the D1/D5 antagonist ecopipam for weight loss in obese subjects

Objective: To evaluate the efficacy and safety of the selective dopamine D1/D5 antagonist ecopipam for the treatment of obesity. Research Methods and Procedures: Four randomized, double‐blind, multicenter trials compared ecopipam (n = 1667) and placebo (n = 1118) in obese subjects including type 2 diabetic subjects. Subjects received oral ecopipam 10, 30, or 100 mg daily for 12 weeks (Phase 2) or 50 or 100 mg daily for 52 weeks (Phase 3) combined with a weight loss program. Primary efficacy variables were the proportion of subjects with ≥5% weight loss from baseline at 12 weeks (Phase 2) or the distribution of percentage weight loss from baseline at 52 weeks (Phase 3). Results: In the Phase 2 study, 26% of subjects administered ecopipam 100 mg vs. 6% of placebo subjects achieved ≥5% weight loss after 12 weeks (p < 0.01). In the Phase 3 studies, ecopipam 100 mg produced a 3.1% to 4.3% greater weight loss than placebo at 52 weeks. More subjects administered ecopipam vs. placebo achieved a 5% to 10% or >10% weight loss in two non‐diabetic phase 3 trials. Ecopipam‐treated subjects also maintained more weight loss compared with placebo subjects at 52 weeks. Phase 3 studies were discontinued because of unexpected psychiatric adverse events (ecopipam 31% vs. placebo 15%), including depression, anxiety, and suicidal ideation. Discussion: Ecopipam was effective for achieving and maintaining weight loss in obese subjects, including type 2 diabetic subjects; however, the adverse effects on mood observed in the Phase 3 studies exclude its projected use in weight management.     

Nutritional Interventions in Depression and Perinatal Depression

Depression is the leading cause of mental disability worldwide. Women who are depressed during pregnancy are at a higher risk for preterm delivery, preeclampsia, birth difficulties, and postpartum depression. The treatment of depression in conventional medicine has focused on physiological factors that lead to impaired neurotransmitter function and treatments to improve neurotransmitter function. Pharmaceutical substances pose risks for pregnant and lactating women, and lower risk options are preferred. Micronutrients, including certain B vitamins, folate, and docosahexaenoic acid (DHA), play a role in the synthesis and absorption of neurotransmitters. Experimental studies suggest that supplementation with specific micronutrients may alleviate depressive symptoms and improve birth outcomes in patients with perinatal depression. Alternative treatments for depression, including nutritional supplements, are an important treatment option for depressive symptoms while limiting potential side effects and treatment costs. This article explores the biological basis of perinatal depression and reviews the potential benefits of non-pharmacological interventions.     

Between a rock and a hard place: evaluating the relative risks of inbreeding and outbreeding for conservation and management

As populations become increasingly fragmented, managers are often faced with the dilemma that intentional hybridization might save a population from inbreeding depression but it might also induce outbreeding depression. While empirical evidence for inbreeding depression is vastly greater than that for outbreeding depression, the available data suggest that risks of outbreeding, particularly in the second generation, are on par with the risks of inbreeding. Predicting the relative risks in any particular situation is complicated by variation among taxa, characters being measured, level of divergence between hybridizing populations, mating history, environmental conditions and the potential for inbreeding and outbreeding effects to be occurring simultaneously. Further work on consequences of interpopulation hybridization is sorely needed with particular emphasis on the taxonomic scope, the duration of fitness problems and the joint effects of inbreeding and outbreeding. Meanwhile, managers can minimize the risks of both inbreeding and outbreeding by using intentional hybridization only for populations clearly suffering from inbreeding depression, maximizing the genetic and adaptive similarity between populations, and testing the effects of hybridization for at least two generations whenever possible.     

Research advances in geriatric depression

Technical advances have facilitated the exploration of factors related to geriatric depression and have helped generate novel biological and psychosocial treatment approaches. This review summarizes the main advancements in epidemiology, clinical presentation and course, genetics, and other areas of biological research. Treatment interventions outlined in this paper include electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, vagus nerve stimulation, deep brain stimulatn, depression prophylaxis, multidisciplinary approaches to depression treatment, and psychotherapy. Forms of psychotherapy for geriatric depression summarized include interpersonal psychotherapy, supportive psychotherapy, cognitive-behavioral therapy, problem-solving therapy, and ecosystem-focused therapy. Neuroimaging techniques based on magnetic resonance imaging are discussed briefly, including volumetric brain studies, diffusion tensor imaging, fractional anisotropy, fiber tractography, magnetization transfer imaging, and blood-oxygenation-level-dependent functional magnetic resonance imaging. Finally, treatment effectiveness is addressed in a discussion of new models to improve access to and quality of care offered in the community.     

When does depression become a disorder? Using recurrence rates to evaluate the validity of proposed changes in major depression diagnostic thresholds

High community prevalence estimates of DSM‐defined major depressive disorder (MDD) have led to proposals to raise MDD's diagnostic threshold to more validly distinguish pathology from normal‐range distress. However, such proposals lack empirical validation. We used MDD recurrence rates in the longitudinal 2‐wave Epidemiologic Catchment Area Study to test the predictive validity of three proposals to narrow MDD diagnosis: a) excluding “uncomplicated” episodes (i.e., episodes that last no longer than 2 months and do not include suicidal ideation, psychotic ideation, psychomotor retardation, or feelings of worthlessness); b) excluding mild episodes (i.e., episodes with only five to six symptoms); and c) excluding nonmelancholic episodes. For each proposal, we used lifetime MDD diagnoses at wave 1 to distinguish the group proposed for exclusion, other MDD, and those with no MDD history. We then compared these groups’ 1‐year MDD rates at wave 2. A proposal was considered strongly supported if at wave 2 the excluded group's MDD rate was not only significantly lower than the rate for other MDD but also not significantly greater than the no‐MDD‐history group. Results indicated that all three excluded groups had significantly lower recurrence rates than other MDD (uncomplicated vs. complicated, 3.4% vs. 14.6%; mild vs. severe, 9.6% vs. 20.7%; nonmelancholic vs. melancholic, 10.6% vs. 19.2%, respectively). However, only uncomplicated MDD's recurrence rate was also not significantly greater than the MDD occurrence rate for the no‐MDD‐history group (3.4% vs. 1.7%, respectively). This low recurrence rate resulted from an interaction between uncomplicated duration and symptom criteria. Multiple‐episode uncomplicated MDD did not entail significantly elevated recurrence over single‐episode cases (3.7% vs. 3.0%, respectively). Uncomplicated MDD's general‐distress symptoms, transient duration, and lack of elevated recurrence suggest it may generally represent nonpathologic intense sadness that should be addressed in treatment guidelines and considered for exclusion from MDD diagnosis to increase the validity of the MDD/normal sadness boundary.     

Parental relatedness and major histocompatibility effects on early embryo survivorship in Atlantic salmon

Salmon have provided key insights into the relative influence of natural and sexual selection on major histocompatibility complex (MHC) variation. Natural selection on salmon MHC genes has been demonstrated in pathogen studies, and there is evidence of MHC-based mate choice (sexual selection). We tested whether parental MHC genes affect survivorship of juvenile Atlantic salmon (Salmo salar) by quantifying the influence of parental genome-wide relatedness and MHC genotype on survivorship to the swim-up stage. Thirteen microsatellite loci were used to estimate the influence of genome-wide relatedness between parents on offspring survivorship and MHC genotypes were determined by sequencing part of the class IIβ gene. Our results revealed no significant relationship between early offspring survivorship and genome-wide relatedness, predicted MHC heterozygosity, or MHC allelic similarity. Overall, our data are consistent with the contention that excess MHC heterozygosity in Atlantic salmon juveniles is due to sexual selection as well as differential survival of offspring due to MHC genotype.     

Depressing synapse as a detector of frequency change

In this article we discuss the short-term synaptic depression using a mathematical model. We derive the model of synaptic depression caused by the depletion of synaptic vesicles for the case of infinitely short stimulation time and show that the analytical formulas for the postsynaptic potential (PSP) and kinetic functions take simple closed form. A solution in this form allows an analysis of the characteristics of depression as a function of the models parameters and the derivation of analytic formulas for measures of short time synaptic depression commonly used in experimental studies. Those formulas are used to validate the model by fitting it to two types of synapses described in the literature. Given the fitted parameters we discuss the behavior of the synapse in situations involving frequency change. We also indicate a possible role of depressing synapses in information processing as not only a filter of high frequency input but as a detector of the return from high frequency stimulation to the stimulation within frequency band specific for a given synapse.     

Admixture between native and invasive populations may increase invasiveness of Mimulus guttatus

Self-fertilization and admixture of genotypes from different populations can have major fitness consequences in native species. However, few studies have addressed their potential roles in invasive species. Here, we used plants of Mimulus guttatus from seven native North American, three invasive Scottish and four invasive New Zealand populations to address this. We created seeds from self-fertilization, within-population outcrossing, between-population outcrossing within the same range, and outcrossing between the native and invasive ranges. A greenhouse experiment showed that native and invasive plants of M. guttatus suffered to similar degrees from inbreeding depression, in terms of asexual reproduction and biomass production. After outcrossing with plants from other populations, M. guttatus benefited from heterosis, in terms of asexual and sexual reproduction, and biomass production, particularly when plants from native and invasive populations were crossed. This suggests that, when novel genotypes of M. guttatus from the native North American range will be introduced to the invasive ranges, subsequent outcrossing with M. guttatus plants that are already there might further boost invasiveness of this species.