RESUMO
Objective:To correlate creatine kinase (CK) and creatine kinase- isoenzyme MB (CK-MB) with different states of bipolar disorder in patients.Methods:A total of 206 patients with bipolar disorder who received treatment in The 7 th People's Hospital of Wenzhou, China between January 2018 and June 2019 were included in the patient group. A total of 369 healthy controls who concurrently received physical examination were included in the control group. CK and CK-MB levels were detected in all participants. The Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD)-7 scale, the Bech-Rafaelsen Melancholy Scale (BRMS), and modified version of the Overt Aggression Scale (MOAS) were used to evaluate the mental symptoms, depression, mania and aggression of patients. The CK and CK-MB levels were compared between patients with different states of bipolar disorder. Results:In the control group, CK and CK-MB levels in males were 112.5 (94.5, 156.5) U/L and 17.0 (15.0, 20.0) U/L, respectively, which were significantly higher than those in females [73.0 (61.0, 86.3) U/L, 15.0 (13.0, 18.0) U/L, Z = -9.732, -3.535, both P < 0.001). In the patient group, CK and CK-MB levels in males were 129.0 (80.0, 233.5) U/L, 12.0 (10.0, 17.0) U/L, respectively, which were significantly higher than those in females [73.0 (55.0, 94.0) U/L, 13.5 (11.0, 17.0) U/L, Z = -9.510, -4.746, both P < 0.001]. There was no significant difference in CK level in males between the control and patient groups ( Z = -1.003, P = 0.316), but significant difference in CK-MB level in males was observed between the two groups ( Z = -6.570, P < 0.001). There were significant differences in CK and CK-MB levels in females between the control and patient groups ( Z = -2.535, -9.707, P = 0.011, P < 0.001). In the patient group, CK level in the manic, depressive, and symptom-alleviated states was 132.0 (78.0, 297.0) U/L, 85.0 (56.0, 145.0) U/L, 128.0 (110.0, 165.0) U/L respectively in males, and it was 73.0 (49.0, 122.3) U/L, 51.0 (45.0, 67.0) U/L and 84.5 (61.0, 193.0) U/L, respectively in females. There was significant difference in CK level in males and females between different states of bipolar disorder ( χ2 = 9.019, 16.720, P = 0.011, P < 0.001). In males, CK level was correlated with the BPRS total score, BRMS total score, and MOAS total score in the manic state, as well as the BPRS total score in the symptom-alleviated state ( r = 0.282, 0.286, 0.236, 0.574). In females, CK level was correlated with the MOAS total score in the manic state ( r = 0.260). In males, CK-MB level was correlated with the BRMS total score in the manic and depressive states ( r = 0.186 and 0.496). In females, CK-MB level was correlated with the MOAS total score and the BRMS total score in the manic state ( r = 0.155, 0.572). Conclusion:CK and CK-MB levels are correlated with bipolar disorder in different states and they are of certain clinical significance and provide innovative insights into the diagnosis of bipolar disorder.
RESUMO
Objective To examine the effects of participating in Balint group ( PBG) for reducing occupational burnout among primary care physicians (PCPs). Methods In this randomized controlled trial, 240 PCPs were randomly assigned to PBG (n=70) and control group (n=240) in propotion of 1 ∶ 2. Sub-jects of PBG received Balint group intervention for one year,while control group received natural observation. Maslach Burnout Inventory ( MBI) was used to assess the severity of occupational burnout. Results At baseline all three subscales of MBI had no significant difference between PBG and cotrol group(P>0. 05). After the intervention,PBG had statistically lower subscale scores in emotional exhaustion ((20. 1±8. 3) vs (22. 6±8. 7),t=1. 993,P=0. 048) and depersonalization (( 6. 8± 4. 9) vs ( 10. 8 ± 5. 2),t=5. 355,P<0. 001) than the control group, while had statistically higher score in personal accomplishment subscale ((38. 3±7. 5) vs (34. 6±7. 7),t=3. 311,P=0. 001) than the control group. Conclusions PBG is effective in reducing occupational burnout among PCPs.
RESUMO
OBJECTIVE To investigate the effect of mono-2-ethylhexyl phthalate(MEHP) on proliferation of primary neural stem cells(NSCs)of rats and NE-4C cells of mice and on the migration of NE-4C cells and the mechanism. METHODS NE-4C or NSCs were treated with MEHP 1,10,100 and 1000 μmol · L-1 for 72 h,respectively. The cytotoxicity was estimated with the cell counting kit-8 (CCK-8). Cell proliferation was analyzed by EdU assay. The mRNA expression levels of the glucocorticoid receptor(GR),signal transducer and activator of transcription 3(Stat3)and sex determining region Y (SRY)-box 2(Sox2) were detected by qRT-PCR. The protein expression levels of total GR,GRβ, Sox2,Stat3 and p-Stat3 were measured by Western blotting. RESULTS Cell viability of NE-4C cells and NSCs at MEHP 1000μmol·L-1 was significantly decreased,which was 70.3%and 40.0%of the control group, respectively. EdU assay showed that MEHP 100 μmol · L-1 decreased NE-4C cells and NSCs by 74.8%and 12.0%(P<0.05)compared with control. The effect of MEHP on the cell migration of NE-4C was evidenced by the fact that the migration was obviously reduced to (63.4±2.0)%(P<0.05)after treatment with MEHP 100μmol · L-1 for 72 h. The mRNA expression levels associated with proliferation and migration in NE-4C of GR,Stat3 and Sox2 in MEHP 100 μmol · L-1 group were down-regulated to 49.8%,26.0% and 14.0%of control(P<0.05). At MEHP 100μmol · L-1,mRNA of GR, Stat3 and Sox2 in NSCs declined to 10.0%,14.0% and 15.3% of normal control. Western blotting results revealed that protein expressions of GR,GRβ,Sox2 and p-Stat3 were remarkably inhibited by MEHP 100 μmol · L-1 in that the relative expression of NE-4C was 0.92 ± 0.17,0.87 ± 0.35,0.81 ± 0.22 and 0.62 ± 0.24(P<0.05). The corresponding protein expression in NSCs was 0.82 ± 0.20,0.56 ± 0.12,0.84 ± 0.36 and 0.53 ± 0.20(P<0.05)when the cells were treated with MEHP 100μmol · L-1 for 72 h. CONCLUSION MEHP can inhibit the proliferation and migration of NE-4C cells and NSCs possibly by decreasing Stat3 and Sox2 that are mediated by GRβ.