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BackgroundMajor depressive disorder is one of the most disabling mental diseases. Currently， medication in combination with physiotherapy and psychotherapy remains the most commonly used treatment modality for the disease， whereas only a few randomized controlled studies have been conducted on physiotherapy， and even fewer studies have focused on medication combined with physiotherapy. ObjectiveTo explore the efficacy and safety profile of repetitive transcranial magnetic stimulation （rTMS） versus modified electroconvulsive therapy （MECT） in combination with antidepressants in the treatment of major depressive disorder， so as to provide an optimized treatment plan for patients with major depressive disorder. MethodsPatients with major depressive disorder （n=335） hospitalized in Shandong Daizhuang Hospital from January 1， 2019 to April 30， 2023 were included， all of whom met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10）. Depending on their disease condition， patients were subjected to either MECT in combination with drugs （n=141） or rTMS in combination with drugs （n=194） after admission. Depressive symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） at the baseline and the end of the 1st， 2nd， 3rd and 4th week of treatment， and the adverse reactions were documented in patient's medical records. ResultsAnalysis of variance on HAMD-24 revealed a significant effect of time （F=3.081， P=0.042）， but no effect of group （F=1.023， P=0.313）， and the interaction effect between the time and the groups was not statistically significant （F=1.642， P=0.191）. No statistical difference was reported between two groups in response rate and full remission rate （P>0.05）. Throughout the course of treatment， 58 cases （41.13%） of recent memory impairment and 74 cases （52.48%） of headache or neck muscle pain occurred in MECT combined with drugs group， and 27 cases （13.92%） in rTMS combined with drugs group experienced headache or head skin discomfort. ConclusionAntidepressants in combination with rTMS or MECT show equivalent efficacy in the treatment of major depressive disorder， while rTMS combined with antidepressants demonstrates a superior safety profile compared to MECT.
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Objective To investigate the efficacy and influencing factors of allo-HSCT in the treatment of MDS patients with ASXL1+.Methods The second-generation sequencing technique was used to detect 22 gene mutations in 247 newly diagnosed MDS patients in our hospital.The patients were divided into chemotherapy group and transplant group according to treatment style.The differences of OS and PFS between the two groups were compared,and the influencing factors of prognosis of transplant patients were analyzed.Results ASXL1+ was detected in 75 patients(30.36%),with a median mutation ratio of 42.93(18.10,58.39)%,10 received supportive treatment,43 received demethylation therapy or demethylation combined with pre-excitation therapy,and 22 received allo-HSCT.2-year PFS rate and OS rate of transplantation group were significantly higher than that of chemotherapy group(P<0.05).The 2-year OS rate in the low ASXL1 mutation load group(VAF≤42.93%)was significantly higher than that in the high ASXL1 mutation load group(VAF>42.93%)(P<0.05).In the context of allo-HSCT in patients with ASXL1+,2-year OS and PFS rates were significantly reduced in patients with RUNX1+ or ASXL1+(P<0.05);Multivariate analysis showed that high mutation load of ASXL1 or U2AF1+ were independent risk factors for OS in transplant patient(P<0.05).U2AF1+ were the risk factors for PFS(P<0.05).Conclusion allo-HSCT significantly improved the prognosis of patients with ASXL1+ MDS.High ASXL1 mutation load or U2AF1+ were independent risk factors affecting the outcome of allo-HSCT.
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Soluble epoxide hydrolase (sEH) is related to arachidonic acid cascade and is over-expressed in a variety of diseases, making sEH an attractive target for the treatment of pain as well as inflammatory-related diseases. A new series of memantyl urea derivatives as potent sEH inhibitors was obtained using our previous reported compound 4 as lead compound. A preferential modification of piperidinyl to 3-carbamoyl piperidinyl was identified for this series via structure-based rational drug design. Compound A20 exhibited moderate percentage plasma protein binding (88.6%) and better metabolic stability in vitro. After oral administration, the bioavailability of A20 was 28.6%. Acute toxicity test showed that A20 was well tolerated and there was no adverse event encountered at dose of 6.0 g/kg. Inhibitor A20 also displayed robust analgesic effect in vivo and dose-dependently attenuated neuropathic pain in rat model induced by spared nerve injury, which was better than gabapentin and sEH inhibitor (±)-EC-5026. In one word, the oral administration of A20 significantly alleviated pain and improved the health status of the rats, demonstrating that A20 was a promising candidate to be further evaluated for the treatment of neuropathic pain.
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Objective:To investigate the information demand level and its influencing factors of cardiac rehabilitation in patients after PCI, in order to provide scientific basis for doctors and nurses to formulate cardiac rehabilitation intervention strategies.Methods:A total of 146 patients after PCI were investigated with general data questionnaire and Cardiac Rehabilitation Inventory in the First Affiliated Hospital of Dalian Medical University from December 2019 to February 2020, and multiple linear regression was used to analyze the influencing factors of cardiac rehabilitation information demand.Results:The average scores of each dimension of Cardiac Rehabilitation Inventory after PCI were autonomy, process anxiety and result anxiety from high to low. Multiple linear regression showed that occupational type was a significant predictor of autonomy of patients after PCI, which could explain 4.6% of the variation of autonomy, and autonomy of in-service patients after PCI was higher than that of retirees ( t=2.81, P<0.05). Sex and age were significant predictors of process anxiety of patients after PCI, which could explain the variation of 8.6% of process anxiety. The occupational type, the medical insurance type and whether they had received professional rehabilitation guidance during hospitalization were significant predictors of anxiety after PCI, which could explain the 15.2% variation of anxiety, and the anxiety of in-service patients after PCI was lower than that of retirees ( t=-3.76, P<0.05). Conclusions:The level of cardiac rehabilitation information needs of patients after PCI is worthy of attention. Medical staff can give targeted, personalized and different forms of cardiac rehabilitation in the process of cardiac rehabilitation, and emphasize the implementation of health education and guidance for their cardiac rehabilitation in order to meet their cardiac rehabilitation information needs, improve their autonomy and alleviate their anxiety.
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With the development of human centered medical nursing model, empowerment as a new and effective nursing intervention model has been widely concerned. In this paper, from the overview of empowerment theory, the influencing factors of the implementation of empowerment theory in patients with chronic heart failure and the strategies to improve the implementation effect of empowerment theory for patients with chronic heart failure. The purpose of this review is to provide reference for the implementation of empowerment theory for patients with chronic heart failure in China.
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PhaseⅡexercise rehabilitation of patients with myocardial infarction is the core stage of the whole exercise rehabilitation process, which plays a vital role in disease rehabilitation and prevention. Previous reviews are difficult to highlight the changes and focus of phaseⅡexercise rehabilitation in patients with myocardial infarction. This article provides a general introduction from the perspective of myocardial infarction patients′ phaseⅡexercise rehabilitation. It summarizes the current status and deficiencies of exercise load assessment method, the types of exercise and effect of the myocardial infarction patient′s phaseⅡexercise rehabilitation, in order to provide reference for the improvement of related studies on exercise rehabilitation.
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ObjectiveTo assess the specificity of P50 auditory-evoked potential in schizophrenic patients with violent and aggressive behaviors， so as to provide objective biological markers for predicting violent behaviors of schizophrenic patients. MethodsA total of135 schizophrenic patients who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） were divided into aggressive group （n=70） and non-aggressive group （n=65） according to the assessment results of the Modified Overt Aggression Scale （MOAS）， meantime， another 60 healthy individuals matched for age and gender were set as healthy group. Then the P50 auditory-evoked potentials of all selected individuals were measured using EP/EMG system （MEB-9200， Nihon Kohden， Japan）. ResultsAmp S2 of the aggressive group was significantly higher than those of the non-aggressive group and healthy control group， with statistical differences ［（9.86±6.04）μV vs. （7.06±3.88）μV， P=0.004； （9.86±6.04）μV vs. （7.82±3.87）μV， P=0.031］. The proportion of S2/S1 ratio ≥0.5 was 72.88%， 43.86% and 30.00% in aggressive group， non-aggressive group and healthy group， which was the highest in aggressive group， with statistical differences （P<0.01）. The amplitude difference of P50 （S1-S2） of the aggressive group was lower than those of the non-aggressive group and the healthy control group， the differences were of statistical significance ［（4.35±9.39）μV vs.（9.89±8.48）μV， P=0.001； （4.35±9.39）μV vs.（13.42±9.81）μV， P<0.01］. ConclusionThe violent and aggressive behaviors in schizophrenic patients may be related to the sensory gating deficit.
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Objective: To study the effects of Rhizoma Polygoni Cuspidati on expression of transforming growth factor beta 1(TGF-?1) in rats with pulmonary fibrosis induced by bleomycin.Method: 120 male SD rats were randomly divided into five groups: the control group(n=30),the bleomycin(BLM) model group(n=30),the Rhizoma Polygoni Cuspidati prophylactic group(n=30),the 7 th day treatment group(n=20) and the 28 th day treatment group(n=10).The rat models of pulmonary fibrosis were established by intratracheal injection of bleomycin, while the control group was given with normal saline instead.The Rhizoma Polygoni Cuspidati prophylactic group received intragastric administration with 4ml?kg-1?d-1 Rhizoma Polygoni Cuspidati 2 days before setting up models.The 7 th day treatment group and the 28 th day treatment group received the treatment on the seventh day and the twenty-eighth days after establishing models respectively.The other two groups received saline instead.On the 3rd,7th,14th,28th,42th and 56th day after instillation of bleomycin,lung samples were obtained and the content of hydroxyproline in lung tissue homogenate was detected to judge the degree of fibrosis and the therapeutic efficacy.At the same time the express of TGF-?1mRNA and TGF-?1 protein was examined by RT-PCR and immunohistochemical method.Results: Compared with the model group,the content of hydroxyproline in the Rhizoma Polygoni Cuspidati prophylactic group and the 7th day treatment group decreased significantly(P