老年肺癌患者化疗期间抑郁情况调查及相关因素分析

目的:调查老年肺癌患者化疗期间抑郁情况及分析其相关因素。方法:选取2012年1月至2016年12月在我院化疗的老年肺癌患者300例,调查统计患者的基本信息资料,采用Zung氏自评抑郁量表(SDS)评价患者的抑郁情况,统计患者抑郁情况的调查结果,并采用Logistic回归分析影响老年肺癌患者抑郁的相关因素。结果:300例老年肺癌的患者当中,在化疗期间有抑郁者164例,占54.67%。其中59例是轻度抑郁,占35.98%;90例是中度抑郁,占54.88%;15例是重度抑郁,占9.15%。单因素分析显示,老年肺癌患者抑郁发生率与年龄、收入水平、TNM分期及有无癌症转移有关(均P0.05),与性别、文化程度、癌症分型无关(P0.05)。多因素Logistic回归分析显示影响老年肺癌患者抑郁的相关因素有年龄≥70岁、收入水平3000元/月、TNM分期为Ⅲ~Ⅳ期以及癌症转移(P0.05)。结论:老年肺癌患者在化疗期间较容易出现抑郁症状,临床上应加以重视,年龄≥70岁、收入水平3000元/月、TNM分期为Ⅲ~Ⅳ期以及癌症转移是影响老年肺癌患者抑郁的相关因素,针对相关因素应尽早采取相应的干预措施,从而有利于改善患者的负性心理情绪。     

Anxiety,depression-like behaviors and biochemistry disorders induced by cannabis extract in female mice

Cannabis is an annual herbaceous plant sometimes grown for decoration and used as bird food that looks like flax. The study wanted to determine if a Cannabis extract may have an effect on how anxious and depressed the female mice behaved. forty healthy female mice were divided into four groups. Tap water was administered to the first group (control). Ethanol was administered to second group (positive control). The third and four groups were given 1 and 2 mg/kg cannabis extract respectively. Treatment continued for 14 days. After therapy, the light–dark chamber, forced swimming, tail suspension, plus lamb and open field tests were done to assess anxiety and depressive behavior. The results indicated that the anxiety and depression were increased in treated females significantly compared to control. Biochemical results showed that DA,5-HT, AChE, GSH, GST, CAT and SOD were decreased while TBARS, corticosterone and cortisol were increased. In conclusion, cannabis effects this kind of females’ behavior but the mechanisms are not clear yet. We need more researches on this trend.     

不同剂量艾司氯胺酮对腹腔镜全子宫切除术患者术后疼痛和情绪状态的影响

摘要 目的：探讨不同剂量艾司氯胺酮对腹腔镜全子宫切除术患者术后疼痛和情绪状态的影响。方法：按照随机数表法,选择2022年1月至2023年4月我院行腹腔镜全子宫切除术患者120例分为对照组（A组,n=40）、艾司氯胺酮0.25 mg/kg组（B组,n=40）、艾司氯胺酮0.5 mg/kg组（C组,n=40）。比较三组组围术期指标、术后1、4、8、24 h和48 h的疼痛评定数字量表（NRS）评分及术前1天（PRE1）、术后第1天（POD1）、术后第2天（POD2）的焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分、血流动力学指标及不良反应。结果：B组和C组术后24 h舒芬太尼镇痛药物用量、补救镇痛例数小于A组,A组、B组苏醒时间、拔管时间短于C组（P＜0.05）。B组、C组术后1 h的NRS评分低于A组（P＜0.05）,B组术后4 h、8 h、24 h的NRS评分低于A组,术后4 h、8 h的NRS评分低于C组（P＜0.05）。与组内PRE1相比,三组POD1的SAS、SDS评分均升高（P＜0.05）。B组、C组POD1、POD2的SAS、SDS评分均低于A组,且C组低于B组（P＜0.05）。与组内PRE1相比,A组POD2的SAS、SDS评分升高（P＜0.05）。与组内PRE1相比,B组POD2的SDS与C组POD2的SAS、SDS均降低（P＜0.05）。在T3时刻,B组和C组的平均动脉压（MAP）、心率（HR）低于A组（P＜0.05）。B组和C组术后恶心呕吐发生率低于A组（P＜0.05）;A组和B组术后头晕、苏醒延迟的发生率低于C组（P＜0.05）;三组术后苏醒期躁动和呼吸抑制的差异无统计学意义（P＞0.05）。结论：0.25 mg/kg的艾司氯胺酮对减轻腹腔镜全子宫切除术患者术后疼痛,减少阿片类药物用量,改善负面情绪的临床效果更佳。     

针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症患者伴胃肠功能紊乱的临床疗效

摘要 目的：探讨针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症患者伴胃肠功能紊乱的临床疗效。方法：选取我院2020年5月到2023年5月收治的80例抑郁症伴胃肠功能紊乱患者作为研究对象,中医证型均为肝郁脾虚型,分为观察组与对照组,40例。对照组患者采取逍遥散合半夏厚朴汤治疗,观察组在对照组基础上增加针灸治疗,对比两组患者临床疗效,分别在治疗前后应用汉密尔顿抑郁量表（HAMD）、负性认知加工偏向问卷（NCPBQ）评价抑郁症状和负性认知情况,并对比治疗前后肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）表达水平和胃动素（motilin,MTL）、生长抑素（SS）、胃泌素（GAS）相关血清肠胃激素表达水平,并采用世界卫生组织生活质量-100量表（WHOQOL-100）评估生活质量。结果：观察组治疗总有效率较对照组高（P＜0.05）;治疗前两组患者HAMD、NCPBQ评分对比无差异（P＞0.05）,治疗后两组患者均降低,且观察组较对照组低（P＜0.05）;治疗前两组患者TNF-α、CRP、IL-6相关炎症因子和MTL、SS、GAS相关胃肠激素水平对比无明显差异（P＞0.05）,治疗后两组患者TNF-α、CRP、IL-6、SS、GAS水平均降低,且观察组较对照组低,MTL水平升高,观察组较对照组高（P＜0.05）;两组患者治疗后生活质量相关评分均升高,且观察组较对照组高（P＜0.05）。结论：针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症伴胃肠功能紊乱疗效显著,可减轻患者抑郁情绪和负性认知,降低炎症反应,改善胃肠激素水平,提升患者生活质量。     

Novel 5-HT7R antagonists,arylsulfonamide derivatives of (aryloxy)propyl piperidines: Add-on effect to the antidepressant activity of SSRI and DRI,and pro-cognitive profile

A novel series of arylsulfonamide derivatives of (aryloxy)propyl piperidines was designed to obtain potent 5-HT₇R antagonists. Among the compounds evaluated herein, 3-chloro-N-{1-[3-(1,1-biphenyl-2-yloxy)2-hydroxypropyl]piperidin-4-yl}benzenesulfonamide (25) exhibited antagonistic properties at 5-HT₇R and showed selectivity over selected serotoninergic and dopaminergic receptors, as well as over serotonin, noradrenaline and dopamine transporters. Compound 25 demonstrated significant antidepressant-like activity in the forced swim test (0.625–2.5 mg/kg, i.p.) and in the tail suspension test (1.25 mg/kg, i.p.), augmented the antidepressant effect of inactive doses of escitalopram (selective serotonin reuptake inhibitor) and bupropion (dopamine reuptake inhibitor) in the FST in mice, and similarly to SB-269970, exerted pro-cognitive properties in the novel object recognition task in cognitively unimpaired conditions in rats (0.3 mg/kg, i.p.). Such an extended pharmacological profile, especially the augmentation effect of the identified 5-HT₇R antagonist on SSRI activity, seems promising regarding the complexity of affective disorders and potentially improved outcomes, including mnemonic performance.     

个性化心理护理对帕金森病伴抑郁状态患者的影响

目的探讨个性化心理护理对帕金森病患者伴抑郁状态的影响。方法选择我院神经内科收治的帕金森病伴抑郁状态患者100例作为研究对象,随机分成对照组和观察组各50例。对照组按帕金森病常规药物治疗和护理,观察组在此基础上给予个性化心理护理,观察两组患者4周后汉密尔顿抑郁量表(HAMD)评定情况。结果通过个性化心理护理后,观察组患者的抑郁发生率明显低于对照组,差异有统计学意义(P0.01)。结论个性化心理护理可显著改善帕金森病患者的抑郁症状,提高患者的生活质量。     

养血清脑颗粒对老年脑梗死后抑郁患者血清胱抑素C及认知功能的影响

目的:探究养血清脑颗粒对老年脑梗死后抑郁患者血清胱抑素C水平的影响及认知功能水平的影响。方法:选取2015年6月到2016年6月我院神经内科收治的老年脑梗死后抑郁患者74例,根据随机数字对照表分为对照组与试验组,各37例。对照组采用口服盐酸帕罗西汀治疗,试验组联合给予养血清脑颗粒治疗,4周为一个疗程,共治疗一个疗程。比较两组患者临床疗效、血清胱抑素C水平及认知功能水平。结果:治疗结束后,与对照组相比,试验组临床总有效率较高(P0.05),治疗后两组血清胱抑素C水平较治疗前降低(P0.05),MMSE评分较治疗前升高(P0.05);与对照组相比,血清胱抑素C水平较低(P0.05),MMSE评分较高(P0.05)。结论:养血清脑颗粒治疗老年脑梗死后抑郁患者临床疗效显著,认知功能明显改善,推测其与血清胱抑素C水平降低有关。     

文拉法辛联合认知行为疗法治疗帕金森病抑郁、认知功能障碍的临床疗效评价

目的:探讨文拉法辛联合认知行为疗法治疗帕金森病(PD)抑郁、认知功能障碍的临床疗效和安全性。方法:选择我院收治的60例PD合并抑郁、认知功能障碍患者并将其随机分为三组,分别为对照组(单用文拉法辛治疗),联合奥氮平组(文拉法辛联合奥氮平),联合认知行为疗法组(文拉法辛联合认知行为疗法),每组20例,于治疗前及治疗后4、8周末采用汉密尔顿抑郁量表(HAMD)进行抑郁程度评定,简易精神状态评价量表(MMSE)和事件相关电位(event-related potentials,ERPs)P300进行认知功能评定。结果:治疗4、8周时,三组的HAMD评分均较治疗前有不同程度下降,P300潜伏期较治疗前有不同程度缩短,P300波幅、MMSE评分有不同程度升高(P0.05),联合奥氮平组和联合认知行为疗法组HAMD评分较对照组明显下降,P300潜伏期较对照组明显缩短,P300波幅、MMSE评分明显升高(P0.05),联合认知行为疗法组HAMD评分较联合奥氮平组明显下降,P300潜伏期明显缩短,P300波幅、MMSE评分明显升高(P0.05)。三组均无特殊不良反应。结论:文拉法辛联合认知行为疗法治疗PD抑郁、认知功能障碍疗效确切,能显著改善患者抑郁症状,提高患者的认知功能,疗效较单用文拉法辛或文拉法辛联合奥氮平治疗更好,且安全性高。     

Mitochondrial Dysfunction and Psychiatric Disorders

Mitochondrial oxidative phosphorylation is the major ATP-producing pathway, which supplies more than 95% of the total energy requirement in the cells. Damage to the mitochondrial electron transport chain has been suggested to be an important factor in the pathogenesis of a range of psychiatric disorders. Tissues with high energy demands, such as the brain, contain a large number of mitochondria, being therefore more susceptible to reduction of the aerobic metabolism. Mitochondrial dysfunction results from alterations in biochemical cascade and the damage to the mitochondrial electron transport chain has been suggested to be an important factor in the pathogenesis of a range of neuropsychiatric disorders, such as bipolar disorder, depression and schizophrenia. Bipolar disorder is a prevalent psychiatric disorder characterized by alternating episodes of mania and depression. Recent studies have demonstrated that important enzymes involved in brain energy are altered in bipolar disorder patients and after amphetamine administration, an animal model of mania. Depressive disorders, including major depression, are serious and disabling. However, the exact pathophysiology of depression is not clearly understood. Several works have demonstrated that metabolism is impaired in some animal models of depression, induced by chronic stress, especially the activities of the complexes of mitochondrial respiratory chain. Schizophrenia is a devastating mental disorder characterized by disturbed thoughts and perception, alongside cognitive and emotional decline associated with a severe reduction in occupational and social functioning, and in coping abilities. Alterations of mitochondrial oxidative phosphorylation in schizophrenia have been reported in several brain regions and also in platelets. Abnormal mitochondrial morphology, size and density have all been reported in the brains of schizophrenic individuals. Considering that several studies link energy impairment to neuronal death, neurodegeneration and disease, this review article discusses energy impairment as a mechanism underlying the pathophysiology of some psychiatric disorders, like bipolar disorder, depression and schizophrenia.     

Reduced Expression of GABA Transporter GAT3 in Helpless Rats,an Animal Model of Depression

Mood disorders have been linked to glial and synaptic pathology such as disturbed neurotransmission of γ-aminobutyric acid (GABA). We evaluated the expression of GABAergic marker genes in rats with helpless behaviour, an animal model of depression. Male Sprague-Dawley rats from inbred lines were tested for helpless behaviour and grouped according to failures in terminating foot shock currents. Expression levels of GABAergic marker genes were assessed using semiquantitative in situ-hybridization. Animals with congenital helpless behaviour (cH) were unable to escape current exposure in contrast to cH-animals derived from the same litters with low failure rates and to non-helpless animals (cNH). We found a significant downregulation of the GABA transporter GAT3 in cLH rats. GAT1 showed small changes, glutamic acid decarboxylase (GAD67) and the vesicular GABA transporter were not significantly altered. Reduced GABA transporter expression is well in concert with the behavioural phenotypes of knockout animals and strengthens the hypothesis of impaired glial functions in depression.