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Objective:To observe the effect of escitalopram combined with repetitive transcranial magnetic stimulation (rTMS) on efficacy and attention function in patients with first-episode unipolar depression.Methods:Fifty-two first-episode initial-naive unipolar depression patients were enrolled in Department of Neurology of Guangzhou First People's Hospital from March 2022 to April 2023 were chosen. They were randomly allocated to active stimulation group ( n=27) and sham stimulation group ( n=25); both were treated with escitalopram, and active treatment or sham treatment in the left dorsolateral prefrontal cortex (DLPFC) were given for 4 weeks (5 d per week, 20 d totally). Before treatment and 2 and 4 weeks after treatment, Hamilton Depression Rating Scale (HAMD)-24 was used to evaluate depressive symptoms, and Birmingham Cognitive Screening Scale-Chinese (BCoS-C) was used to evaluate the attention function. Results:(1) In terms of depressive symptoms: HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment (20.63±2.73, 15.85±2.43) were significantly lower than those before treatment (25.74±2.68, P<0.05); HAMD-24 scores of sham stimulation group 4 weeks after treatment were also significantly lower than those before treatment ([20.48±2.33] vs. [25.80±2.57], P<0.05); HAMD-24 scores of the active stimulation group 2 and 4 weeks after treatment were significantly lower than those of sham stimulation group ( P<0.05). (2) In terms of auditory attention indicators: total correct number (selective attention) in active stimulation group 4 weeks after treatment was significantly larger than that before treatment (51.74±1.38 vs. 47.48±1.60), and the sustained index (sustained attention) was significantly lower than that before treatment (0.74±0.71 vs. 4.37±1.15, P<0.05); total correct number in active stimulation group 4 weeks after treatment was significantly larger than that in sham stimulation group (48.00±1.66), and the sustained index was significantly lower than that in sham stimulation group (3.72±1.28, P<0.05). Conclusion:Combined with escitalopram, rTMS can more effectively mitigate the depressive symptoms in first-episode unipolar depression patients, and depressive symptoms improve more quickly than attentional function.
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Objective To observe the functional connectivity of attentional network in first-episode treatment-naive depressed patients with resting-state functional MR imaging (rfMRI),and to investigate the neuropathologic mechanism of attention dysfunction.Methods Eighteen first-episode treatment-naive depressed patients were collected in our hospital from August 2015 to March 2017,and 16 healthy controls matched with age,gender and education were chosen at the same time period.All subjects accepted rfMRI.Pearson correlation analysis was performed on all the time series values of the two regions of interest (ROIs),and their correlation coefficient was obtained.Fisher z transformation was performed to reflect the functional connection strength of the two ROIs through z scores.Results As compared with healthy controls,depressed patients showed abnormal enhancement on functional connectivity of the attentional network in the left anterior cingulate and supplementary motor area (z scores:0.21 ±0.10 vs.0.13±0.09,P=0.029),right basal ganglia region and dorsolateral prefrontal cortex (z scores:0.18±0.12 vs.0.10±0.08,P=0.048),right frontal eye field and intraparietal suleus (z scores:0.19± 0.12 vs.0.10±0.05,P=0.006),right frontal eye field and nucleus ceruleus (z scores:0.18±0.13 vs.0.09± 0.07,P=0.018).Conclusion Abnormal functional connectivity of attentional network exists extensively in first-episode treatment-naive depressed patients,which may be due to attention impairment in depressed patients.
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Objective To investigate the characteristics and significance of sural sparing pattern and radial sparing pattern in children immune-mediated acute or chronic inflammatory peripheral neuropathy.Methods Forty children with Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) aged<14 years, admitted to our hospital from September 2014 to August 2019, were chosen as immune-inflammatory group; 15 children (<14 years old) with multiple peripheral neuropathy of other etiologies from the same source were classified as other etiologies group. The characteristics of sensory nerve damage measured by nerve conduction velocity in the two groups were compared. The existences of sural sparing (SS) pattern and radial sparing (RS) pattern, and sensory ratio (SR)>1 were conformed. SR=(sural nerve sensory nerve action potentials+radial nerve sensory nerve action potentials)/(median nerve sensory nerve action potentials+ulnar nerve sensory nerve action potentials).Results (1) In 40 patients from immune-inflammatory group, 38 were GBS and two were with CIDP; Among the 38 with GBS, 34 were with acute inflammatory demyelinatingpolyneuropathies (AIDP), 3 were with acute motor axonal neuropathy (AMAN), and one was with acute motor sensory axonal neuropathy. Among the 15 patients from the other etiologies group, 9 were with charcot-marie-tooth (CMT) type 1, one was with CMT type 2, one was with CMT intermediate type, and two were with hereditary neuropathy with liability to pressure palsies (HNPP), and two were with mitochondrial disease involves polyneuropathy. (2) As compared with patients from other etiologies group, patients from immune-inflammatory group had significantly higher positive rates of SS (72.5％vs. 6.7％) , RS(42.5％vs.6.7％) and SR>1 (75.0％vs.13.3％). In the diagnoses of childhood acute or chronic inflammatory polyneuropathy, the sensitivity of SS pattern was 0.73, specificity was 0.93, and positive likelihood ratio was 10.88. SR>1 had moderate specificity (0.87) and low sensitivity (0.41).Conclusion The sensory sparing patterns, especially SS pattern, have valuable clinical significance in the diagnoses of acute or chronic inflammatory peripheral neuropathy in children.
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Objective To analyze and research the Chinese medicine of tonifying kidney recipe on the mechanism of recurrent spontaneous abortion IL-4, IFN-gamma cytokine.Methods60 patients in accordance with the inclusion criteria with recurrent miscarriage from January 2013 to December 2015 were selected, according to the random number table method, the patients were randomly divided into Chinese medicine group, Western medicine group,Combine traditional Chinese and western medicine group, Chinese medicine group treated with traditional Chinese medicine of tonifying kidney recipe, Western Medicine group were given intramuscular injection of progesterone injection,combining traditional Chinese and Western medicine group was treated with acupuncture combined with progesterone Chinese medicine.The course of treatment was 15 days, before and after treatment in patients with pregnancy outcome and IL-4, IFN-gamma levels.ResultsThere was no significant difference between the three groups before treatment with IL-4 and IFN-.After treatment,compared with the traditional Chinese and Western medicine group, western medicine group, Chinese medicine group of IL-4, IFN-, respectively, showed a rise and fall, the difference was statistically significant(P<0.05).After treatment, compared with the traditional Chinese medicine group, the IL-4 and IFN-of the western medicine group were increased and decreased, respectively, and the difference was statistically significant (P<0.05).Combination of traditional Chinese and Western medicine to obtain a higher clinical cure rate.ConclusionThe combination of TCM and Western medicine for improving the efficacy of pregnancy outcome of recurrent spontaneous abortion and exact expression may obviously improve the IL-4 and IFN-gamma, help to improve the IL-4, reduce the expression of IFN-gamma, improve the outcome of pregnancy.
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Objective To compare the efficacy and safety of intravenous thrombolysis on cardiogenic cerebral infarction and noncardiac infarction by recombinant tissue plasminogen activator (rt-PA). Methods Comparations of NIHSS, mRS and adverse events before and after treatment were made between the cardiogenic group and the noncardiac group. Results No significant differences in the NIHSS and mRS were found between the two groups. The incidence of brain hernia and dermatorrhagia in the cardiogenic group was higher than that in the noncardiac group. Conclusion Rt-PA therapy in cardiogenic cerebral infarction was effective and safe in spite of higher incidence of hemorrhage and brain hernia.
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Objective To investigate the incidence and the related factors of the depression in Parkinson's disease. Methods 52 cases with idiopathic Parkinson's disease were included in this study. Such scales as Hamilton depression scale-24 item (HAMD-24), Non Motor Symptoms Scale for Parkinson's disease (NMSS), 39-item Parkinson's Disease Questionnaire (PDQ-39), unified Parkinson's disease rating scale (UPDRS), revised Hoehn-Yahr rating scale (H-Y), revised Schwab and English daily life event scale (S-E), Minimum Mental State Examination (MMSE), etc. were applied and underwent Spearman correlation analysis. Results Thirty-six patients with Parkinson's disease (69.23%) met the criteria for depression. The spearman rank correlation analysis showed that MMSE (r=-0.294, P=0.036) and S-E (r=-0.506, P<0.001) had negative correlation with depression in Parkinson's disease, and the course of the disease (r=0.274, P=0.049), UPDRS (r=0.485, P<0.001), H-Y (r = 0.459, P = 0.001), NMSE (r = 0.729, P < 0.001) and PDQ-39 (r = 0.619, P < 0.001) had positive correlation with depression in Parkinson's disease. Conclusions The patients with Parkinson's disease had high incidence of depression. The depression in Parkinson's disease is associated with many factors and affected the quality of life of the patients.
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ObjectiveTo observe the healing effect of deep partial thickness burns by the injecting of breviscapine and discuss the possible mechanisms. Methods A rat model of deep partial thickness burns was designed,and was injected with breviscapine.The control group was injected with normal saline.The healing time of burn wound of the two groups was recorded,respectively.Seven days later,the tissues of bum wound of each group were extracted and the contents of hydroxyproline,collagenase-1,nitrogen monoxidum,erythrocuprein,and malonaldehyde that were contained in each extracts were measured.The results of each group were statistically analyzed.ResultsThe healing time of burn wound of the experimental group was [ ( 12 ± 1.428 ) days ],which was significantly shorter than the control group [ ( 14.75 ±1.291 )days] ( P ＜0.05).The contents of hydroxyproline[ (3.17 ± 1.136) mg/g],collagenase-1 [ ( 1.28± 0.651 ) mg/g ],nitrogen monoxidum [ ( 2.62 ± 0.30 ) μmol/gprot ],and erythrocuprein [ ( 221.25 ±25.94) U/mgprot ] in the experimental group were all higher than the control group [ (7.32 ± 2.173 )mg/g,(5.38 ±0.363) mg/g,(7.28 ± 0.40) μmol/gprot,(296.36 ± 29.29) U/mgprot ] ( P ＜ 0.05 or P ＜0.01 ).However,the content of malonaldehyde [ (6.36 ± 0.93 ) nmol/mgprot ] was lower than the control group [ ( 1.25 ± 0.59) nmoL/mgprot ] ( P ＜ 0.05 ).ConclusionsThe breviscapine injection can decurtate the healing time of deep partial thickness bums and it may be related to the extension of blood vessel,improvement of microcirculation,elimination of oxygen free radical,and degradation of lipid peroxidation.
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Objective To explore the clinical features,risk factors and the sensitivity to antibiotics of lower respiratory tract acinetobacterial infection.Methods The clinical data,results of sputum bacterial culture and drug sensitivity of the 72 cases with lower respiratory tract acinetobacterial infection were netrospectively reviewed.Results 53 cases(73.6%)were elder than 60 years old,69 cases(95.8%)had basic diseases,and 59 cases(81.9%)were nosocomial infection.Risk factors included basic diseases,lower immune function,all kinds of invasive operations,aerosol inhalation,unreasonable usage of antibiotics.Drug sensitivity test showed that the drugs which sensitive to acinetobacter was upper than 50% included Imipenen,Levofloxacin,Cefooerazone/sulbactum and Amikacin.Conclusion The patients who sufferred from lower respiratory tract acinetobacterial infection usually are elder than 60 years old,and have basic diseases.Most of this kind of infection is nosocomial infection.Because of severe clinical symptom and high drug resistant rate,the prognosis is poor.Reasonable selection of sensitive antibiotics is important.
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Objective To discuss the clinical characteristics of thalamic hemorrhage,the correlative risk factor and the factors influencing prognosis.Method The clinical datas of 74 cases of thalamic hemorrhage and CT examination results were analyzed to find out the relationship between the clinical characteristics and the prognosis.Results The old age and hypertension were the main causes of thalamic hemorrhage.The mortality of thalamic hemorrhage that rupturing into ventricle was higher than that not rupturing into ventricle.Conclusions The old age and hypertension are the main causes of thalamic hemorrhage.The clinical manifestation of thalamic hemorrhage is variety.The prognosis is related weith age,blood pressure and the present of rupturing into ventricle.
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Objective To explore the etiology of pulmonary atelectasis and explore the value of fiberoptic bronchoscope in the diagnosis and treatment of pulmonary atelectasis.Methods 192 cases of pulmonary atelectasis confirmed by thoracic X-ray and CT were examined and treated under fiberoptic bronchoscope.Results The final cause of 192 cases pulmonary atelectasis was lung cancer in 122 cases,chronic inflammation in 35 cases,tuberculosis in 24 cases,foreign body in 3 cases,blood clot obstruction in 3 cases,no clear causes in 5 cases;97.4% of pulmonary atelectasis were diagnosed.The treatment of pulmonary atelectasis caused by tumor obstruction was ineffective under fiberoptic bronchoscope;Then for others,atelectasis of patients was re-expanded completely in 65.7% after treatment one week under fiberoptic bronchoscope,re-expanded partially in 27.1% and the effective rate was 92.8%.Conclusion The rate of etiologic diagnosis of pulmonary atelectasis under fiberoptic bronchoscope is high;The main causes of pulmonary atelectasis are lung cancer,chronic inflammation and tuberculosis.The pulmonary atelectasis with no clear cause should be examined with fiberoptic bronchoscope.The treatment under fiberoptic bronchscope is effective for non-tumor atelectasis.