Brain structural alterations in MDD patients with gastrointestinal symptoms: Evidence from the REST-meta-MDD project.

OBJECTIVE: While gastrointestinal (GI) symptoms are very common in patients with major depressive disorder (MDD), few studies have investigated the neural basis behind these symptoms. In this study, we sought to elucidate the neural basis of GI symptoms in MDD patients by analyzing the changes in regional gray matter volume (GMV) and gray matter density (GMD) in brain structure. METHOD: Subjects were recruited from 13 clinical centers and categorized into three groups, each of which is based on the presence or absence of GI symptoms: the GI symptoms group (MDD patients with at least one GI symptom), the non-GI symptoms group (MDD patients without any GI symptoms), and the healthy control group (HCs). Structural magnetic resonance images (MRI) were collected of 335 patients in the GI symptoms group, 149 patients in the non-GI symptoms group, and 446 patients in the healthy control group. The 17-item Hamilton Depression Rating Scale (HAMD-17) was administered to all patients. Correlation analysis and logistic regression analysis were used to determine if there was a correlation between the altered brain regions and the clinical symptoms. RESULTS: There were significantly higher HAMD-17 scores in the GI symptoms group than that of the non-GI symptoms group (P < 0.001). Both GMV and GMD were significant different among the three groups for the bilateral superior temporal gyrus, bilateral middle temporal gyrus, left lingual gyrus, bilateral caudate nucleus, right Fusiform gyrus and bilateral Thalamus (GRF correction, cluster-P < 0.01, voxel-P < 0.001). Compared to the HC group, the GI symptoms group demonstrated increased GMV and GMD in the bilateral superior temporal gyrus, and the non-GI symptoms group demonstrated an increased GMV and GMD in the right superior temporal gyrus, right fusiform gyrus and decreased GMV in the right Caudate nucleus (GRF correction, cluster-P < 0.01, voxel-P < 0.001). Compared to the non-GI symptoms group, the GI symptoms group demonstrated significantly increased GMV and GMD in the bilateral thalamus, as well as decreased GMV in the bilateral superior temporal gyrus and bilateral insula lobe (GRF correction, cluster-P < 0.01, voxel-P < 0.001). While these changed brain areas had significantly association with GI symptoms (P < 0.001), they were not correlated with depressive symptoms (P > 0.05). Risk factors for gastrointestinal symptoms in MDD patients (p < 0.05) included age, increased GMD in the right thalamus, and decreased GMV in the bilateral superior temporal gyrus and left Insula lobe. CONCLUSION: MDD patients with GI symptoms have more severe depressive symptoms. MDD patients with GI symptoms exhibited larger GMV and GMD in the bilateral thalamus, and smaller GMV in the bilateral superior temporal gyrus and bilateral insula lobe that were correlated with GI symptoms, and some of them and age may contribute to the presence of GI symptoms in MDD patients.

[Clinical Research on Double-needle Winding and Pulling Combined with Electroacupuncture Therapy in Treating Scapulohumeral Periarthritis].

OBJECTIVE: To observe the efficacy of double-needle winding and pulling combined with electroacupuncture in treating scapulohumeral periarthritis. METHODS: Sixty cases with scapulohumeral periarthritis were equally randomized into treatment group and control group (n=30 in each group). Jianliao (TE 14), Jianyu(LI 15), Naoshu(SI 10), Jianzhen(SI 9), Binao(LI 14), Quyuan(SI 13), Quchi(LI 11), Shousanli(LI 10) were selected in the two groups. In the treatment group,double-needles were inserted respectively into TE 14,LI 15 and SI 10, twirling till sticking,then the needles were pulled for 3 times.The rest acupoints were manipulated routinely before electroacupuncture apparatus was connected. The control group received routine electroacupuncture treatment. Both groups were treated for 2 courses, which comprised of 6 days as a course and 1 day rest. VAS and Melle were scored and clinical efficacy was evaluated for both groups. RESULTS: VAS and Melle scores were lower after treatment than those before in both groups (P<0.001), and the scores in the treatment group were significantly lower than those in the control group (P<0.001). The before-and-after-treatment difference values of VAS and Melle scores in the treatment group were significantly higher than those of the control group (P<0.01). There were 8 cases cured, 17 observed markedly effective and 4 effective in the treatment group, the rate of cured and markedly effective was 83.3%, which was significantly higher (P<0.01) than that of the control group (50.0%), in which 0 cases cured, 15 observed markedly effective, 13 effective. No significant difference was observed between the two groups in total effective rate (P>0.05). No adverse event occurred during the treatment. CONCLUSIONS: The therapy of double-needle winding and pulling combined with electroacupuncture has good efficacy in treating scapulohumeral periarthritis,which can relieve pain and improve the shoulder joint function, and it is superior to single electroacupuncture therapy.

Effect of total flavonoids from the seeds of Astragali complanati on natural killer cell function.

ETHNOPHARMACOLOGICAL RELEVANCE: The seeds of Astragalus complanatus R.Br. (AC), a traditional Chinese medicine, have been extensively used for clinical treatment of liver and kidney complaints and tumors for more than a thousand years. It was believed that AC is warm and sweet in the most authoritative medical book of Ancient China "Compendium of Materia Medica". Our previous studies showed that the flavonoid component from the seeds of Astragalus complanatus (FAC) is mainly an active constituent and has the hepatoprotective effect, anti-liver fibrosis, and anti-tumor and immune enhancement. AIM: The aim of this study was to investigate in vitro the regulation effect of FAC on NK cells function and possible mechanism of action. METHODS: The effect of FAC on the proliferation ability of NK-92 cells and the cytolysis of NK-92 cells to K562 and SMMC-7721 were measured by MTT assay and lactase dehydrogenase (LDH)-releasing assay, respectively. The phenotypical characterization (CD3, CD16 and CD56) and activation markers (CD25, CD69 and CD95) of NK-92 cell were detected by flow cytometry analysis. IFN-γ production of NK-92 cells stimulating by K562 cells was quantitated using ELISA. To explore the mechanism of action, mRNA and protein expressions of activating receptors (NKp30, NKp44, NKp46 and NKG2D) in NK-92 cells were detected by quantitative real-time PCR and flow cytometry analysis. RESULTS: Our results demonstrated that FAC significantly promoted the proliferation and the cytotoxicity of NK-92 cells in a dose-dependent manner by enhancing IFN-γ and increasing the expression of the activation markers CD25 and CD69. In addition, FAC had not changed the NK-92 cells phenotypical characterization, but markedly enhanced the expression intensity of CD56. Furthermore, FAC significantly enhanced mRNA and protein expressions lever of NKp44 and NKG2D in NK-92 cells. CONCLUSION: These results suggest that FAC upregulate the expressions of NKG2D, NKp44, which in turn influence NK-92 cells activation. FAC may serve as an immunostimulatory of NK cells for tumor treatment.

Wogonin suppresses human alveolar adenocarcinoma cell A549 migration in inflammatory microenvironment by modulating the IL-6/STAT3 signaling pathway.

Increasing evidence from various clinical and experimental studies has demonstrated that the inflammatory microenvironment facilitates tumor metastasis. Clinically, it will be a promising choice to suppress tumor metastasis by targeting inflammatory microenvironment. Our previous studies have demonstrated that wogonin (a bioflavonoid isolated from the traditional Chinese medicine of Huang-Qin) possesses the anti-metastatic and anti-inflammatory activity, but we have little idea about its efficacy on inflammatory-induced tumor metastasis and the mechanism underlying it. In this study, we focused on epithelial mesenchymal transition (EMT), the first step of tumor metastasis, to evaluate the effects of wogonin on tumor metastasis in inflammatory microenvironment. We found that wogonin inhibited THP-1 conditioned-medium- (CM-) and IL-6-induced EMT by inactivating STAT3 signal. And in wogonin-treated A549 cells which pretreated with THP-1 CM or IL-6, the expression level of E-cadherin, an EMT negative biomarker, increased while that of N-cadherin, Vimentin, and EMT-related transcription factors including Snail and Twist decreased. Moreover, wogonin inhibited IL-6-induced phosphorylation of STAT3, prevented p-STAT3 dimer translocation into the nucleus, and suppressed the DNA-binding activity of p-STAT3. Interestingly, similar results were obtained in the tumor xenografts mice, including downregulation of p-STAT3, N-cadherin, and Vimentin while up-regulation of E-cadherin. Wogonin also inhibit the metastasis of A549 cells in vivo. Taken all data together, we concluded that wogonin suppresses tumor cells migration in inflammatory microenvironment by inactivating STAT3 signal.

A randomized controlled trail of combination therapy of neuromuscular electrical stimulation and balloon dilatation in the treatment of radiation-induced dysphagia in nasopharyngeal carcinoma patients.

Dysphagia is a most common complication induced by radiotherapy in nasopharyngeal carcinoma (NPC) patients. This randomized controlled trail (RCT) was performed to evaluate the therapeutic effect of combination therapy of neuromuscular electrical stimulation (NMES) and balloon dilatation in the treatment of radiation-induced dysphagia in NPC patients. Sixty NPC patients with radiation-induced dysphagia were assigned to either the combination rehabilitation group (treatment group) or the routine rehabilitation group (control group) at random. Both groups were subjected to routine rehabilitation treatment, while the combination rehabilitation group also received combination therapy of NMES and balloon dilatation for 4 months. The water swallow test (WST) and videofluoroscopic swallowing study (VFSS) were used to evaluate the severity of dysphagia. The treatment group showed a significant improvement in swallowing function when compared with the control group. When the WST was used, the efficacy rate (percentage of patients with excellent and effective results) of treatment group was higher than that of control group (90.1 vs. 76.3%), and the difference was statistically significant (χ(2) = 8.55, p = 0.036). When the VFSS was used, the videofluoroscopy results in our study showed that the values of oral transit time (OTT), swallow reaction time (SRT), pharyngeal transit time (PTT) and laryngeal closure duration (LCD) in treatment group were notably improved when compared with those in control group. In conclusion, combination rehabilitation treatment can improve swallow function in the treatment of radiation-induced dysphagia in NPC patients.

A meta-analysis of the efficacy of acupuncture in treating dysphagia in patients with a stroke.

BACKGROUND: Dysphagia, or deglutition difficulty, is a common manifestation in patients with a stroke and its management is an important aspect of rehabilitation. Acupuncture, a complementary and alternative therapy, is the subject of growing public interest for treatment of stroke. OBJECTIVE: A meta-analysis was performed to study the effect of acupuncture for treatment of dysphagia in patients affected by a stroke. METHODS: Randomised controlled trials (RCTs) comparing acupuncture treatment with non-acupuncture treatment of dysphagia in patients with a stroke were identified from the databases of PubMed, Embase, Cochrane Library and CBM disc (China Biological Medicine Database). Eligible investigations were included and data on the effectiveness of acupuncture were extracted and synthesised by meta-analysis using RevMan 5.1.4. Results were expressed as OR for dichotomous data; 95% CIs were also calculated. RESULTS: Seventy-two RCTs (3208 patients in the treatment group and 2926 patients in the control group) were identified. Details of randomisation and blinding were not reported and information on withdrawals and dropouts was missing in most of included reports. Meta-analysis showed that the effectiveness of treatment in the group receiving acupuncture was higher than that in the non-acupuncture group (OR=5.17, 95% CI 4.18 to 6.38; p<0.00001). However, the study quality was generally low and of insufficient quality to make recommendations about using acupuncture in the rehabilitation of patients with dysphagia due to stroke. CONCLUSIONS: Acupuncture might be beneficial in the rehabilitation of patients with dysphagia caused by stroke, and the evidence justifies future high-quality studies.

[Proton magnetic resonance spectroscopy of the thalamus and hypothalamus in patients with first-episode depression].

OBJECTIVE: To investigate the presence of abnormal metabolism in the thalamus and hypothalamus in patients with first-episode depression. METHODS: Thirty drug-naive patients with first-episode depression and 30 age-matched controls were scanned with proton magnetic resonance spectroscopy ((1)H-MRS) for Naa, Cho, Cr and mI. RESULTS: Compared with the control group, the patients showed significantly reduced mI and mI/Cr of the hypothalamus, reduced mI/Cr of the left thalamus, and lowered Cho, ml, and ml/Cr of the right thalamus (P<0.05). CONCLUSION: Patients with first-episode depression may have myo-inositol and phosphoric acid metabolism disorder in the thalamus and hypothalamus with malfunction of cellular osmotic pressure adjustment mechanism. Abnormal mI/Cr in the thalamus and hypothalamus may represent an important biochemical change in advanced patients with depression.