Thresholds for Ambulatory Blood Pressure Monitoring Based on Maternal and Neonatal Outcomes in Late Pregnancy in a Southern Chinese Population.

Background In contrast to the general population, outcome-derived thresholds for diagnosing ambulatory hypertension in pregnancy are not yet available. We aimed to identify and compare outcome-derived ambulatory blood pressure (BP) monitoring thresholds for adverse perinatal outcomes by using approaches related and not related to clinic BP in a southern Chinese population. Methods and Results Ambulatory BP monitoring was performed in a cohort of 1768 high-risk participants in late pregnancy who were not taking antihypertensive medications. Participants were followed for composite maternal (severe complications) and neonatal (pregnancy loss, advanced neonatal care, and small for gestational age) outcomes. Modeling of clinic BP-unrelated approaches revealed a nonlinear threshold effect of ambulatory diastolic BP on the composite outcome, with increased risk for daytime ≥79 mm Hg and 24-hour measurement ≥76 mm Hg. For other ambulatory BP components showing linear associations with outcome, the following thresholds were identified: 131 mm Hg for daytime systolic, 121 mm Hg for nighttime systolic, 130 mm Hg for 24-hour systolic, and 73 mm Hg for night-time diastolic BP. These thresholds unrelated to clinic BP were lower than the equivalents yielding a similar probability of outcome to clinic BP of 140/90 mm Hg and were comparable with equivalents to clinic BP of 130/80 mm Hg. Conclusions Using an outcome-derived approach unrelated to clinic BP, we identified rounded thresholds to define ambulatory hypertension in at-risk women in late pregnancy in a southern Chinese population as follows: 130/80 mm Hg for daytime, 120/75 mm Hg for nighttime, and 130/75 mm Hg for 24-hour measurement. For wider clinical applicability and to align both nonpregnancy and pregnancy ambulatory BP monitoring with an outcomes-based approach, prospective, multiethnic, international studies from early pregnancy onward will be required.

Excessive umbilical cord coiling confers risk of elevated nocturnal blood pressure and severe/early-onset preeclampsia.

BACKGROUND: The associations between umbilical cord coiling, feto-placental vascular resistance and maternal blood pressure (BP) are not well understood. METHOD: We retrospectively analyzed 502 pregnant women suspected of hypertensive disorders in the third trimester from a hospital-based cohort, who underwent ambulatory BP monitoring and umbilical artery Doppler velocimetry examinations within 14 days before delivery. By applying quantile regression, a significant quantile-dependent positive association between umbilical cord coiling index and umbilical artery pulsatility index (UAPIMOM; converted to multiples of median) was observed from above 0.75th quantiles for each parameter. RESULTS: Using the cutoffs both at the 0.75th quantile to define high umbilical cord coiling (≥0.28 coils/cm) and high UAPIMOM (≥1.30), respectively, a graded increase in BP level was observed from patients with both low, either high and both high categories. Multivariate linear and quantile regression revealed that the high umbilical cord coiling/high UAPIMOM interaction was significantly correlated with night-time mean DBP level. Moreover, umbilical cord hypercoiling (≥0.3 coils/cm) was significantly correlated with night-time DBP with an average increase of ∼5 mmHg from the 0.05th to 0.70th quantiles and independently predicted the occurrence of severe (odds ratio 2.32, 95% confidence interval: 1.22-4.41) and early-onset (odds ratio 2.43, 95% confidence interval: 1.18-4.97) preeclampsia after adjusting for covariates. Further mediation analysis showed that elevated high UAPIMOM (≥1.30) could explain 11.4% of the umbilical cord hypercoiling → high night-time DBP association. CONCLUSION: Therefore, this retrospective study identifies excessive umbilical cord coiling, and its interaction with increased feto-placental vascular resistance, as novel risk factors for nocturnal BP elevation and preeclampsia.

Trimester-Specific Weight Gain and Midpregnancy Diastolic Blood Pressure Rebound During Normotensive Pregnancy.

The longitudinal exposure-response relationship between trimester-specific gestational weight gain (GWG) and blood pressure (BP) during pregnancy is not well understood. We retrospectively assessed 1112 uncomplicated, normotensive pregnant women whose body weight and BP were measured from 12+0 to 40+0 weeks of gestation from a hospital-based cohort. By using growth curve modeling, a J-shaped pattern dominated diastolic BP (DBP) changing dynamics, with a midpregnancy drop at 20+0 to 22+0 weeks followed by a rebound. Using group-based trajectory modeling, 3 distinctive trajectories of DBP were identified: high-J shaped (18.5%), moderate-J shaped (48.3%), and low-J shaped (33.1%), as well as 3 distinctive GWG trajectories: high increasing (14.7%), moderate increasing (48.6%) and low increasing (36.8%). A temporal coincidence between the maximal rate of GWG and DBP transition from its nadir to rebound was observed during 20+0 to 22+0 weeks. Moreover, women in the high-increasing GWG group had the highest probability of being in the high-J DBP group. The GWG rate during the late midsecond trimester (22+0 to 26+0 weeks) was consistently associated with an elevated DBP level: for every 200 g/wk increase, the multivariable-adjusted odds ratio was 1.27 (95% confidence interval, 1.13-1.43) for the trajectory shift to the high-J group and 1.20 (95% confidence interval, 1.07-1.35) for the occurrence of diastolic prehypertension after 37+0 weeks. Furthermore, adding a trimester-specific GWG rate (22+0 to 26+0 weeks) contributed to the incremental yield for the prediction of diastolic prehypertension after 37+0 weeks. Our results thus provide the timing and extent of gestational weight control relevant to the optimized BP level during pregnancy.

Antidepressant effect of electroacupuncture regulates signal targeting in the brain and increases brain-derived neurotrophic factor levels.

Electroacupuncture improves depressive behavior faster and with fewer adverse effects than antidepressant medication. However, the antidepressant mechanism of electroacupuncture remains poorly understood. Here, we established a rat model of chronic unpredicted mild stress, and then treated these rats with electroacupuncture at Yintang (EX-HN3) and Baihui (DU20) with sparse waves at 2 Hz and 0.6 mA for 30 minutes, once a day. We found increased horizontal and vertical activity, and decreased immobility time, at 2 and 4 weeks after treatment. Moreover, levels of neurotransmitters (5-hydroxytryptamine, glutamate, and γ-aminobutyric acid) and protein levels of brain-derived neurotrophic factor and brain-derived neurotrophic factor-related proteins (TrkB, protein kinase A, and phosphorylation of cyclic adenosine monophosphate response element binding protein) were increased in the hippocampus. Similarly, protein kinase A and TrkB mRNA levels were increased, and calcium-calmodulin-dependent protein kinase II levels decreased. These findings suggest that electroacupuncture increases phosphorylation of cyclic adenosine monophosphate response element binding protein and brain-derived neurotrophic factor levels by regulating multiple targets in the cyclic adenosine monophosphate response element binding protein signaling pathway, thereby promoting nerve regeneration, and exerting an antidepressive effect.

Prehypertension During Normotensive Pregnancy and Postpartum Clustering of Cardiometabolic Risk Factors: A Prospective Cohort Study.

The nonstratification of blood pressure (BP) levels may underestimate future cardiovascular risk in pregnant women who present with BP levels in the range of prehypertension (120-139/80-89 mm Hg). We prospectively evaluated the relationship between multiple antepartum BP measurements (from 11(+0) to 13(+6) weeks' gestation to term) and the occurrence of postpartum metabolic syndrome in 507 normotensive pregnant women after a live birth. By using latent class growth modeling, we identified the following 3 distinctive diastolic BP (DBP) trajectory groups: the low-J-shaped group (34.2%; DBP from 62.5±5.8 to 65.0±6.8 mm Hg), the moderate-U-shaped group (52.6%; DBP from 71.0±5.9 to 69.8±6.2 mm Hg), and the elevated-J-shaped group (13.2%; DBP from 76.2±6.7 to 81.8±4.8 mm Hg). Notably, the elevated-J-shaped trajectory group had mean DBP and systolic BP levels within the range of prehypertension from 37(+0) and 26(+0) weeks of pregnancy, respectively. Among the 309 women who completed the ≈1.6 years of postpartum follow-up, the women in the elevated-J-shaped group had greater odds of developing postpartum metabolic syndrome (adjusted odds ratio, 6.55; 95% confidence interval, 1.79-23.92; P=0.004) than the low-J-shaped group. Moreover, a parsimonious model incorporating DBP (membership in the elevated-J-shaped group but not in the DBP prehypertension group as identified by a single measurement) and elevated levels of fasting glucose (>4.99 mmol/L) and triglycerides (>3.14 mmol/L) at term was developed, with good discrimination and calibration for postpartum metabolic syndrome (c-statistic, 0.764; 95% confidence interval, 0.674-0.855; P<0.001). Therefore, prehypertension identified by DBP trajectories throughout pregnancy is an independent risk factor for predicting postpartum metabolic syndrome in normotensive pregnant women.

A microarray study of chronic unpredictable mild stress rat blood serum with electro-acupuncture intervention.

In the present study, we investigated the changes of microRNA (miRNA) expression upon depression and electro-acupuncture (EA) intervention in chronic unpredictable mild stress (CUMS) rats using microarray analysis. Results showed that EA intervention remarkably improved behavioral indexes in terms of crossing number, rearing number, sucrose preference and body weight of CUMS rats. Microarray analysis revealed that a total of 153 differentially expressed miRNAs were regulated by CUMS, and the expression of 180 differentially expressed miRNAs was changed after EA intervention. Among these miRNAs, two miRNAs were significantly up-regulated and four miRNAs were significantly down-regulated by CUMS. Moreover, four miRNAs were significantly up-regulated and 12 miRNAs were significantly down-regulated after EA intervention. The expressions of miR-383-5p and miR-764-5p were up-regulated after CUMS, while their expressions were down-regulated by EA intervention. Further analysis showed that 1260 possible target genes were predicted for miR-383-5p and miR-764-5p, and 97 pathways and 137 gene ontology (GO) were involved. Among these pathways and GO, about 20 pathways and 21 GO were related to depression. Changes of miR-383-5p and miR-764-5p indicated that EA might exert its therapeutic effect on depression through promoting the neurotrophy and inhibiting the abnormal apoptosis of neurons as well as other correlative signal pathways. In conclusion, our present study enriched the understanding of pathological process of depression and revealed possible mechanisms of EA on depression.

A comparison study of metformin only therapy and metformin combined with Chinese medicine jianyutangkang therapy in patients with type 2 diabetes: A randomized placebo-controlled double-blind study.

The aim of this 26-week, double-blind, controlled clinical trial, was to compare the efficacy of monotherapy (metformin only) with combination therapy (Chinese medicine prescription JianYuTangKang [JYTK] plus metformin) on type 2 diabetes. All patients on metformin were randomized to receive authenticated JYTK (59 patients) or placebo JYTK (53 patients), 4.5g daily, for 26 weeks. Patients also received information regarding diet and exercise. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1C) level, and a lipid profile were measured before, during, and after the treatment. The results of the treatment group (JYTK plus metformin) were noninferior to those of the control group (metformin plus placebo) at 8 and 18 weeks. After 26 weeks of treatment, FPG levels decreased to 6.1±1.0mmol/L in the treatment group and 7.0±1.5mmol/L in the control group (p<0.01). HbA1C levels after 26 weeks were also significantly decreased in the treatment group compared with the control group (p<0.01). In addition, lipid profiles were also significantly different between the two groups. Integrated traditional Chinese and Western medicine therapy (JYTK plus metformin) for patients with type 2 diabetes mellitus may not only help improve glycemia and insulin sensitivity, but also help to modify the diabetes related lipid equilibrium. And thereby provides a basis for a novel, effective, and safe approach, to treat type 2 diabetic patients.

[Evaluation of the diagnostic criteria of gestational metabolic syndrome and analysis of the risk factors].

OBJECTIVES: To investigate gestational multiple metabolic abnormalities aggregation and diagnostic criteria for gestational metabolic syndrome (GMS), and to analyze the risk factors of GMS. METHODS: A cohort study recruiting 309 pregnant women with preeclampsia, 627 pregnant women with gestational diabetes mellitus (GDM) and 1245 normal pregnant women was performed from January 2008 to December 2011 in Guangdong Women and Children's Hospital. Information regarding age, gestational weeks, basic blood pressure, admission blood pressure, height and body mass index(BMI)before pregnancy was recorded. Biochemical indicators including fasting plasma glucose (FPG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), free fatty acids (FFA) were tested. GMS was diagnosed with three or all of the following conditions: (1) overweight and/or obesity before pregnancy (BMI ≥ 25 kg/m(2)); (2) hypertension with blood pressure ≥ 140/90 mm Hg (1 mm Hg = 0.133 kPa); (3) hyperglycemia:diagnosed as GDM; (4) dyslipidemia with TG ≥ 3.23 mmol/L. The incidence of GMS of the three groups were calculated and the risk factors were analyzed. RESULTS: (1) The age, gestational weeks, basic blood pressure, admission blood pressure, BMI before pregnancy of women with preeclampsia and women with GDM were significantly different compared to normal women, respectively (P < 0.01). (2) Biochemical indicators of women with preeclampsia were as following: FPG (4.6 ± 1.0) mmol/L, FINS (10.1 ± 5.6) mU/L, TC (6.3 ± 1.6) mmol/L, TG (3.9 ± 1.8) mmol/L, HDL-C (1.4 ± 0.4) mmol/L, LDL-C (3.0 ± 1.0) mmol/L, FFA (0.8 ± 0.4) mmol/L. And those in women with GDM were: FPG (4.7 ± 0.9) mmol/L, FINS (10.2 ± 5.8) mU/L, TC (5.7 ± 1.3) mmol/L, TG (3.2 ± 1.1) mmol/L, HDL-C (1.4 ± 0.4) mmol/L, LDL-C (2.7 ± 0.9) mmol/L, FFA (0.6 ± 0.3) mmol/L. In normal pregnant women they were: FPG (4.3 ± 0.5) mmol/L, FINS (9.0 ± 4.4) mU/L, TC (5.7 ± 1.1) mmol/L, TG (2.8 ± 1.1) mmol/L, HDL-C (1.5 ± 0.4) mmol/L, LDL-C (2.9 ± 0.8) mmol/L, FFA (0.6 ± 0.2) mmol/L. Statistic differences were found in preeclampsia and GDM women compared to normal women respectively (P < 0.01). (3) The prevalence of GMS in preeclampsia group and in GDM group was 26.2% (81/309) and 13.6% (85/627), statistically different from that of the control group (0)(P < 0.01). (4) Compared to normal women, women with preeclampsia had higher risk of developing GMS (OR = 1.62, 95%CI 1.31 - 2.00, P < 0.01). The risk factors were BMI (OR = 1.29, 95%CI 1.13 - 1.47) and TG (OR = 2.49, 95%CI 1.87 - 3.31). Also, women with GDM had higher risk of developing GMS than normal women (OR = 1.27, 95%CI 1.09 - 1.49, P < 0.01), and the risk factors were BMI (OR = 1.13, 95%CI 1.04 - 1.23) and TG (OR = 1.16, 95%CI 1.02 - 1.33). TG was the independent risk factor in both preeclampsia women and GDM women (P < 0.01, P < 0.05). HDL-C seemed to have less importance in identifying GMS (P > 0.05). CONCLUSIONS: According to the GMS diagnostic criteria used in this study, some preeclampsia patients and some GDM women had aggregation of multiple metabolic abnormalities including pre-pregnancy overweight/obesity, hyperglycemia, high blood pressure and dyslipidemia. TG was the independent risk factor for GMS. HDL-C seemed to have less importance in identifying GMS.

Serum levels of the adipokine chemerin in preeclampsia.

OBJECTIVE: Hypothesising that maternal serum chemerin levels may be associated with preeclampsia, we investigated whether maternal serum chemerin levels differ between preeclamptic and healthy pregnant women. We also investigated the association of serum chemerin with metabolic parameters and the severity of the disease. METHODS: This case-control study included 144 women (72 healthy and 72 preeclamptic women) in the third trimester of a singleton pregnancy. Clinical data and maternal serum were collected. The two groups were carefully matched for maternal age and gestational age. The maternal levels of serum chemerin were determined by enzyme-linked immunosorbent assay. RESULTS: The serum chemerin levels were found to be significantly increased in the women with preeclampsia (258.85±86.64 ng/mL) as compared with the healthy pregnant controls (210.80±47.34 ng/mL) (P<0.001). The serum chemerin concentrations in the severely preeclamptic women (289.6±74.43 ng/mL) were higher than those in the mildly preeclamptic women (228.1±87.99 ng/mL) (P<0.001). A stepwise regression analysis showed that the serum chemerin levels significantly and positively correlated with systolic blood pressure (P<0.001), free fatty acids (P<0.05) and serum creatinine (P<0.01). CONCLUSIONS: Chemerin levels are significantly increased in preeclampsia and independently associated with markers of dyslipidemia and with the severity of the preeclampsia. Further studies need to show the onset of the chemerin increase and its putative involvement in the pathophysiology of preeclampsia.

The relevance between symptoms and magnetic resonance imaging analysis of the hippocampus of depressed patients given electro-acupuncture combined with Fluoxetine intervention - A randomized, controlled trial.

OBJECTIVE: To probe the relevance between depressive symptoms and hippocampal volume and its metabolites detected by magnetic resonance imaging (MRI) in depressed patients who were given electro-acupuncture (EA) combined with Fluoxetine before and after treatment. METHODS: A randomized, controlled trial was conducted. A total of 75 cases of mild or moderate depression were randomly assigned to two groups: the EA group which received EA combined with Fluoxetine; the Fluoxetine group which received Fluoxetine only as the control. The 17-item Hamilton Scale for Depression (HAMD) was used to assess the depression level. The relevance between the changes of the hippocampal volume and its metabolites, including N-acetyl aspartate (NAA)/creatine (Cr) and choline containing compounds (Cho)/Cr, and the reduction rate of the HAMD score before and after treatment of the two groups were analyzed. RESULTS: At the end of the treatment, the therapeutic response rates were not statistically different between the two groups (73.53% for the Fluoxetine group and 83.33% for the EA group, respectively). Compared to that of the Fluoxetine group, a significant difference was shown in the EA group in the reduction rate of the HAMD scores (P<0.05). There was a negative correlation between the therapeutic effect and the HAMD scores before treatment in both groups of patients. There was no significant difference in the hippocampal volume before and after treatment. The NAA/Cr ratio of both groups increased after treatment, with the EA group increasing more. There was a negative correlation between the rate of change of the NAA/Cr after treatment and the HAMD scores before treatment in the two groups. In the Fluoxetine group, the Cho/Cr ratio showed no significant difference before and after treatment, which had no relevance with the HAMD scores before treatment either. Meanwhile, in the EA group, the Cho/Cr ratio showed a significant difference before and after treatment, which also had a positive relevance with the HAMD scores before treatment. CONCLUSIONS: There was a significant improvement in the hippocampal metabolites in depressed patients who treated by EA combined with Fluoxetine. Those differences showed relevance with the HAMD scores before treatment.

[Effect of Shuyusan on neuropeptide Y and serotonin expression in the hippocampal neurons of rats with chronic mild unpredictable stress-induced depression].

OBJECTIVE: To investigate the effect of Shuyusan decoction on neuropeptide Y (NPY) and serotonin (5-HT) expression in the hippocampus and plasma of rats with chronic mild unpredictable stressors depression. METHODS: Fifty Wistar rats were randomly divided into 5 groups, namely the normal control group, model group, fluoxetine group, and high- and low-dose Shuyusan groups. Except for those in the normal control group, all the rats were subjected to chronic mild unpredicted stress for 21 consecutive days with corresponding treatments. Open-field test was used to assess the behavioral changes of the rats. The content of NPY in the hippocampus and plasma was detected by competitive enzyme-linked immunosorbent assay, and immunocytochemistry was used to determine the expression of 5-HT in the hippocampus. RESULTS: NPY levels in the hippocampus and plasma was significantly decreased in the model group as compared with that in the normal control group (P<0.05). Treatments with fluoxetine and high-dose Shuyusan both significantly increased NPY levels in the hippocampus and plasma in the depressive rats (P<0.05), resulting also in significantly increased 5-HT-immunoreactive neurons in the cerebral cortex and hippocampus and the average optical density (P<0.05). CONCLUSION: Shuyusan decoction can effectively increase plasma and hippocampus NPY levels and the number of 5-HT-positive neurons in the cerebral cortex and happocampus of rats with chronic mild unpredictable stress-induced depression.

Efficacy evaluation for depression with somatic symptoms treated by electroacupuncture combined with Fluoxetine.

OBJECTIVE: This study is to investigate the clinical therapeutic effects and safety of treating mild or moderate depression with somatic symptoms with electroacupuncture combined with Fluoxetine. METHODS: 95 cases of mild or moderate depression with somatic symptoms were randomly divided into a Fluoxetine group, and an electroacupuncture plus Fluoxetine group. Hamilton Depression Scale (HAMD) was used for the assessment of clinical therapeutic effects and Treatment Emergent Symptom Scale (TESS) was used for assessment of adverse reactions. RESULTS: The total effective rate was 77.27% in the Fluoxetine group and 78.26% in the electroacupuncture plus Fluoxetine group, showing no statistically significant difference between these two groups (P > 0.05). However, the treatment took effect after two weeks in the electroacupuncture plus Fluoxetine group but after four weeks in Fluoxetine group. During this time, a better therapeutic effect on depression with mild or moderate somatic symptoms was found in the electroacupuncture plus Fluoxetine group, which also had fewer adverse reactions than the Fluoxetine group. CONCLUSION: Electroacupuncture combined with Fluoxetine takes effect faster for relieving the somatic symptoms with fewer adverse reactions. It is worth popularizing clinically.

[Study on electroacupuncture treatment of depression by magnetic resonance imaging].

OBJECTIVE: To explore the changes of metabolites in brain after treatment by analysis on 1H-MRS examination of the hippocampus and prefrontal lobe in the healthy volunteers and the depression patients. METHODS: Seventy-five cases of mild and moderate depression were randomly divided into groups A, B and C, 25 cases in each group. The group A was treated with oral administration of Prozac capsule, 20 mg/d; the group B by electroacupuncture for 30-40 min and the needle was retained for 1 h, once each day, with main points Baihui (GV 20), Yin-tang (GV 29) and adjuvant acupoints selected; the group C by combination of the treatment methods in the groups A and B. They were treated for 6 weeks. Use PROBE-J sequence at the MRI system on Single Voxel of ROI of each lateral of hippocampus and frontal lobe in the depression patients of the 3 groups. Compare the differences of N-acetylasp artate/creatine (NAA/Cr) and choline/creatine (Cho/Cr) between the healthy volunteers and the patients before and after treatment. RESULTS: Before treatment, NAA/Cr in the bilateral hippocampus decreased in the 3 groups as compared with the control group, and after treatment, NAA/Cr in the bilateral hippocampus of the group B and in the right hippocampus of the group C increased compared with that before treatment (P < 0.05), and NAA/Cr in the left hippocampus of the group C significantly increased as compared with that before treatment (P < 0.01). Before treatment, Cho/Cr in the bilateral prefrontal lobe in the 3 groups increased as compared with that in the control group (P < 0.05), after treatment, Cho/Cr in the bilateral prefrontal lobes of the groups A, B and C significantly decreased as compared with that before treatment (P < 0.05, P < 0.01). CONCLUSION: There are differences in contents of metabolites in corresponding parts in bilateral frontal lobes and hippocampus between the depression patient and healthy person.

[Effects of electroacupuncture at different acupoint groups on behavior activity and p-CREB expression in hippocampus in the rat of depression].

OBJECTIVE: To observe therapeutic effects and mechanisms at different acupoint groups for treatment of the depression rat. METHODS: Fifty Wistar rats were randomly divided into a normal group, a model group, a body acupoint group, a scalp acupoint group and a Fluoxetine hydrochloride group, 10 cases in each group. Depression rat model was established by using chronic unpredictable mild stress stimulation combined with lonely breeding for 21 days. EA (2 Hz, 1 mA, 20 min) was given at "Taichong" (LR 3), "Neiguan" (PC 6) and "Zusanli" (ST 36) in the body point group and "Baihui" (GV 20), "Yintang" (EX-HN 3), "Sishencong" (EX-HN 1) in the head point group, once daily, and Fluoxetine hydrochloride was given to the Fluoxetine hydrochloride group by intragastric administration, 2 mg/kg, once daily, for 21 days. Body weight of the rat was recorded, and the sucrose-intake test and forced swimming test were conducted one day before the experiment and on the 7th, 14th and 21st day of the experiment, and the open field test was conducted one day before the experiment and on the 21st day. p-CREB expression in the hippocampus of the rats were observed on the 22nd day. RESULTS: As compared with the model group, in the head point group and the Fluoxetine group, the crossing and rearing movement times, the relative volume of sucrose-intake and p-CREB expression in the hippocampus increased significantly, and the duration of immovability in forced swimming test shortened significantly (P<0.05). The relative volume of sucrose-intake increased and the duration of immovability in forced swimming test in the body point group significantly shortened (P<0.05), but the crossing and rearing movement times and p-CREB expression in the hippocampus did not insignificantly increase (P>0.05), with no significant differences among the treatment groups (P>0.05). CONCLUSION: EA at the head acupoints can improve behavioral activities and increase positive neuron number of p-CREB in the hippocampus of the depression rat, and selection of acupoints is of important role in treatment of depression.

[Assessment of effectiveness of electroacupuncture and fluoxetine for treatment of depression with physical symptoms].

OBJECTIVE: To study on clinical therapeutic effect and safety of electroacupuncture and Fluoxetine for treatment of mild or moderate depression with physical symptoms. METHODS: Seventy-five cases were randomly divided into a western medicine group (group A), an electroacupunctue group(group B) and an electroacupuncture plus medicine group (group C), 25 cases in each group. The group A were treated by oral Fluoxetine, 20 mg each day; the group B by electroacupuncture with Baihui (GV 20) and Yintang (EX-HN 3) selected as main points; the group C by oral administration of Fluoxetine plus electroacupunctue. HAMD depression scale was used for assessment of clinical therapeutic effect and TESS adverse reaction scale was used for adverse reactions. RESULTS: The clinical effective rate was 78.3% in the group A, 82.6% in the group B and 91.7% in the group C, with significant differences between group C and A, group C and B (P < 0.05). Groups B and C had significant therapeutic effects in improvement of physical symptoms, and the adverse reaction of Fluoxetine in the group C was less than that in the group A. CONCLUSION: Electroacupuncture can significantly improve physical symptoms and relieve adverse reactions of Fluoxetine. Electroacupuncture combined with Fluoxetine has a better therapeutic effect on depression with mild or moderate physical symptoms, with less adverse reactions.