Prescriptions for Treating Depression by Tonifying Deficiency： A Review / 中国实验方剂学杂志

Depression is a mental or affective disorder， whose occurrence is closely related to the physical， psychological， and social environmental factors. Clinically， patients with depression often present with significant and long-lasting blue mood， impaired thinking and cognitive functions， reduced mobility， and even self-harm and suicide attempts. The pathogenesis of depression is complex and diverse， and there mainly exist the neurotransmitter hypothesis， immunodeficiency hypothesis， hypothalamus-pituitary-adrenal （HPA） axis activation hypothesis， brain-derived neurotrophic factor （BDNF） hypothesis， and intestinal flora hypothesis. In western medicine， it is mostly treated with antidepressant drugs， but the resulting side effects and repeated attack cannot be ignored. Traditional Chinese medicine（TCM） has obvious advantages in dealing with depression. The advocates of treating "Qi"， "phlegm"， "stasis"， and "five zang organs" have all been proved effective. Depression is characterized by a long course of disease and repeated attack， which coincides with the concept of "deficiency" in TCM. Tonifying deficiency is a method for treating depression based on TCM syndrome differentiation. Under the guidance of this principle， the formulated prescriptions will produce the desired effects. This article reviewed the related clinical and experimental studies on depression treatment via deficiency tonification in recent years， and summarized the corresponding prescriptions for benefiting Qi， replenishing blood， nourishing Yin， and tonifying yang， respectively， so as to enrich the TCM theory of depression and provide new ideas for its clinical treatment.

Association of Source of Memory Complaints and Increased Risk of Cognitive Impairment and Cognitive Decline: A Community-Based Study / 中华医学杂志(英文版)

<p><b>Background</b>Memory complaint is common in the elderly. Recently, it was shown that self-report memory complaint was predictive of cognitive decline. This study aimed to investigate the predictive value of the source of memory complaints on the risk of cognitive impairment and cognitive decline in a community-based cohort.</p><p><b>Methods</b>Data on memory complaints and cognitive function were collected among 1840 Chinese participants (aged ≥55 years old) in an urban community at baseline interview and 5-year follow-up. Incident cognitive impairment was identified based on education-adjusted Mini-Mental State Examination score. Logistic regression model was used to estimate the association between the source of memory complaints and risk of cognitive impairment conversion and cognitive decline, after adjusting for covariates.</p><p><b>Results</b>A total of 1840 participants were included into this study including 1713 normal participants and 127 cognitive impairment participants in 2009. Among 1713 normal participants in 2009, 130 participants were converted to cognitive impairment after 5 years of follow-up. In 2014, 606 participants were identified as cognitive decline. Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment (odds ratio [OR] = 1.60, 95% confidence interval [CI]: 1.04-2.48) and cognitive decline (OR = 1.30, 95% CI: 1.01-1.68). Furthermore, this association was more significant in males (OR = 2.10, 95% CI: 1.04-4.24 for cognitive impairment and OR = 1.87, 95% CI: 1.20-2.99 for cognitive decline) and in higher education level (OR = 1.79, 95% CI: 1.02-3.15 for cognitive impairment and OR = 1.40, 95% CI: 1.02-1.91 for cognitive decline).</p><p><b>Conclusions</b>Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment conversion and cognitive decline, especially in persons with male gender and high educational background.</p>

Effect of hyperventilation on cerebral blood flow, brain metabolism and cerebral perfusion in patients with traumatic brain injury by PETCO2 monitoring / 中华神经医学杂志

Objective To investigate the effect ofhyperventilation on cerebral blood flow,brain metabolism and cerebral perfusion in patients with traumatic brain injury by end tidal pressure of CO2 (PETCO2) monitoring.Methods Seventy patients with traumatic brain injury,admitted to our hospital from January 2009 to June 2012 and performed decompressive craniectomy,were chosen in our study; they were randomly divided into group A and group B (n=35); patients in the group A accepted PETCO2 within 20-25 mm Hg and arterial partial pressure of carbon dioxide (PaCO2) within 22-25 mm Hg,and patients in the group B received PETCO2 within 25-30 mm Hg and PaCO2 within 30-45 mm Hg.The blood gas pressure,mean artery pressure,cerebral oxygen partial pressure,cerebral perfusion pressure,cerebral oxygen supply and demand balance,and changes of neuron specific enolase (NSE),glucose and lactic acid were compared between the two groups at the beginning of craniectomy.Results The PaCO2 level,mean artery pressure,intracranial pressure,and levels of NSE,glucose and lactic acid in group A were significantly lower than those in group B (P＜0.05); while the brain oxygen partial pressure,cerebral perfusion pressure,arterial oxygen content (CaO2),venous oxygen content (CjvO2) and cerebral oxygen uptake rate (CERO2) showed no significant difference between the two groups (P＞0.05).Conclusion PETCO2 controlling within 20-25 mm Hg can effectively maintain the cerebral blood perfusion and cerebral oxygen supply and demand balance of the patients; it can also reduce the pathological metabolite effect on the brain tissue; therefore,its clinical value is worthy for attention.