Evaluation of Mood Disorder Questionnaire (MDQ) in patients with mood disorders: a multicenter trial across China.

BACKGROUND: The aim of this study was to test the ability of the Chinese version of the Mood Disorder Questionnaire (MDQ) to identify Bipolar Disorders (BD) in patients diagnosed with Major Depressive Disorder (MDD) or Unipolar Disorder (UD) in the clinical setting. METHODS: 1,487 being treated for MDD or UD at 12 mental health centers across China, completed the MDQ and subsequently examined by the Mini International Neuropsychiatric Interview (MINI). Receiver Operating Characteristic(ROC) curves were used to determine the ability of the MDQ to differentiate between BD (BD, BD-I and BD-II) and MDD or UD and patients with BD-I from patients with BD-II. RESULTS: Of the 1,487 patients, 309 (20.8%) satisfied the DSM-IV criteria for BD: 118 (7.9%) for BD-I and 191 (12.8%) for BD-II. When only part one of the MDQ was used, the best cutoff was 7 between BD and UD (sensitivity 0.66, specificity 0.88, positive predictive value 0.59, negative predictive value 0.91), 6 between BD-II and UD, and 10 between BD-I and BD-II. If all three parts of the MDQ were used, the MDQ could not distinguish between BD and UD at a cutoff of 7 (or 6), and the sensitivity was only 0.22 (or 0.24). CONCLUSION: The Chinese version of the MDQ had good psychometric features in screening bipolar disorders from depressive patients with mood disorders when part two and part three of the MDQ were ignored.

Abnormalities of cortical-limbic-cerebellar white matter networks may contribute to treatment-resistant depression: a diffusion tensor imaging study.

BACKGROUND: White matter abnormalities can cause network dysfunction that underlies major depressive disorder (MDD). Diffusion tensor imaging (DTI) is used to examine the neural connectivity and integrity of the white matter. Previous studies have implicated frontolimbic neural networks in the pathophysiology of MDD. Approximately 30% of MDD patients demonstrate treatment-resistant depression (TRD). However, the neurobiology of TRD remains unclear. METHODS: We used a voxel-based analysis method to analyze DTI data in young patients with TRD (n = 30; 19 males, 11 females) compared with right-handed, age- and sex-matched healthy volunteers (n = 25; 14 males, 11 females). RESULTS: We found a significant decrease in fractional anisotropy (FA) (corrected, cluster size >50) in the left middle frontal gyrus (peak coordinates [-18 46-14]), left limbic lobe uncus (peak coordinates [-18 2-22]), and right cerebellum posterior lobe (peak coordinates [26-34 -40]). There was no increase in FA in any brain region in patients. We also found a significant negative correlation between mean regional FA values in the three areas and Beck Depression Inventory symptom scores. CONCLUSIONS: We found significant differences in white matter FA in the frontal lobe, limbic lobe and cerebellum between TRD patients and controls. These data suggest that abnormalities of cortical-limbic-cerebellar white matter networks may contribute to TRD in young patients.

Hypomanic symptoms assessed by the HCL-32 in patients with major depressive disorder: a multicenter trial across China.

AIM: To investigate the results of the Hypomania Checklist-32 (HCL-32) administered as a screening instrument in clinical settings to mood disorders patients in the depressive phase. METHODS: A total of 1487 patients diagnosed and being treated for major depressive disorder (MDD) in 13 mental health centers across China were self-rated by the HCL-32 and independently examined by the Mini International Neuropsychiatric Interview (MINI). RESULTS: After examination by the MINI, 309 (20.8%) of the 1487 patients clinically diagnosed as having MDD satisfied DSM-IV criteria for bipolar disorder (BD): 118 (7.9%) for bipolar I disorder (BD-I) and 191 (12.8%) for bipolar II disorder (BD-II). The mean HCL-32 score of the BD patients was statistically higher than that of patients with unipolar depression (UD, major depressive disorder), BD-II higher than UD, while no significant difference between BD-I and BD-II. The HCL-32 distinguished between BD and UD (best cutoff score 14), between BD-II and UD (best cutoff 12). At the optimum cutoff of 12 between BD and UD, the sensitivity was 0.86, specificity 0.69. LIMITATIONS: No standardized instruments were used to measure the severity of depressive symptoms. Depressed patients with a previous history of BD were excluded from this study. CONCLUSIONS: The HCL-32 results in this multicenter study of patients in the depressive phase were similar to those of earlier, generally smaller-scale studies which subjects could be in any mood phases. A score of 12 could be used as the optimum cutoff between BD and UD to improve screening for BD-II if the HCL-32 was applied in clinical settings in China.

Validity of the 32-item Hypomania Checklist (HCL-32) in a clinical sample with mood disorders in China.

BACKGROUND: The 32-item Hypomania Checklist (HCL-32), a questionnaire for screening bipolar disorders, has been utilised in several countries, but it unclear if the Chinese version of the HCL-32 is valid. METHODS: Consecutive patients with bipolar disorders (BP, N = 300) and unipolar major depression (UP, N = 156) completed the Chinese version of the HCL-32. The subjects underwent a structured clinical interview for DSM-IV Axis-I disorders (SCID). RESULTS: The eigenvalues for the first three factors in the HCL-32 were calculated as 5.16 (active/elated), 2.72 (risk-taking) and 2.48 (irritable) using factor analysis. Cronbach's alpha for the HCL-32 was calculated to be 0.88. Positive responses to twenty-eight items were significantly more frequent by patients with BP than those with UP, and the other four items (7th, 21st, 25th and 32nd) showed no such trend. Fourteen was the optimal cut-off for discriminating between BP and UP. The HCL-32 distinguished between BP-II and UP, with 13 being the optimal cut-off. A cut-off of 13 yielded a sensitivity of 0.77 and a specificity of 0.62 between BP and UP. CONCLUSIONS: This study demonstrated that the simplified Chinese version of HCL-32 was valid for patients with mood disorders. The optimal cut-off of 13 for distinguishing between BP-II and UP was valid and could be used to improve the sensitivity of screening BP-II patients when the HCL-32 is used in psychiatric settings in China.

Validity of the Chinese version Mood Disorder Questionnaire (MDQ) and the optimal cutoff screening bipolar disorders.

To investigate the validity of the Chinese version of Mood Disorder Questionnaire (C-MDQ) in China. Patients with bipolar disorders (BP, N=284) and patients with unipolar depressive disorder (UP, N=134) were assessed with the C-MDQ. The Eigenvalues of the first two factors were 3.15 and 2.09, respectively. The Cronbach's alpha of the C-MDQ was 0.79. The frequency of positive responses of UP patients was significantly lower than those of BP patients for 12 items except the seventh item. A C-MDQ screening score of seven or more was the best cutoff between BP and UP. The C-MDQ could distinguish between bipolar II disorder (BP-II) and UP, and the best cutoff was five. A cutoff of five had a sensitivity of 0.80 and a specificity of 0.54 between BP and UP. This study demonstrated the good validity of C-MDQ in China. The best cutoff between BP-II and UP can be regarded as the optimal cutoff between BP and UP to improve the sensitivity of screening for BP-II. Five should be the optimal cutoff between the BP and UP when only the 13 items of the questionnaire are used in China.

The separate roles of endothelin receptors participate in remodeling of matrix metalloproteinase and connexin 43 of cardiac fibroblasts in maladaptive response to isoproterenol.

Stress may affect gap junction connexin 43 and matrix metalloproteinase-2/9 (MMP-2/9) in cardiac fibroblasts, potentially contributing to worsening cardiac function and arrhythmias. Cardiac fibroblasts isolated from neonatal rat were incubated with isoproterenol at 3 x 10(-7) M to mimic stress and were treated with either PD156707 or IRL-1038 (selective antagonists for endothelin A and B receptor respectively) and CPU0213 (a dual endothelin A/B receptor antagonist) at 1 x 10(-8) M, 3 x 10(-8) M or 1 x 10(-7) M. RT-PCR and Western blotting were conducted. Upregulation of the two endothelin receptors, MMP-2/9 and NADPH oxidase subunits (p22phox and p47phox), and downregulation of connexin 43 in cardiac fibroblasts were found in the presence of isoproterenol and were attenuated by the selective blockers PD156707 and IRL-1038 in a dose-dependent manner. IRL-1038 was less effective. CPU0213 appeared to be more effective than the two selective blockers in blocking these changes. Changes in cardiac fibroblasts in response to isoproterenol mediated by upregulation of the endothelin-NADPH oxidase pathway may play a role in deteriorating cardiac function and arrhythmias. The endothelin A receptor has a major role, relative to the endothelin B receptor, in the remodeling of cardiac fibroblasts during isoproterenol stimulation. CPU0213, a dual endothelin receptor A/B blocker, seems to be more effective in normalizing these changes than do the selective endothelin receptor antagonists.

[Study on adsorption of nonpolar R-side amino acids on silver nanoparticles by FT-SERS].

The adsorption orientation and adsorption characteristics of aliphatic-nonpolar amino acids represented by L-methionine on silver nanoparticles were studied by FT-surface-enhanced Raman spectroscopy (FT-SERS) method with different pH and concentrations. According to the experiments, in order to get the best FT-SERS effects, the optimal concentration range of the L-methionine on silver sol is between 10(-3) mol x L(-1)-10(-4)(mol x L(-1). The FT-SERS effects and adsorption model change with pH; The SERS are poor when pH is near the isoelectric point or over 11 or 3. The interaction of L-methionine with Ag nanoparticles is the physical and chemical adsorption by NH3, COO-, S, which could also be effected by pH. From the results and previous reports on this aspect, the general rules of the adsorption model and the orientation of the aliphatic-nonpolar amino acids on silver nanoparticles were speculated, which would be useful for the study of amino acids, protein, peptide, enzyme etc.

[FT-Raman spectroscopic investigation on hypothyroid cancer].

The normal and malignant tissues from hypothyroid were investigated by FT-Raman spectroscopy. The results show that two characteristic Raman spectral peaks of normal tissues appeared at 503 and 758 cm(-1) (corresponding to theextension vibration of C--I band and the vibration of benzene rings respectively) in the range of 400-3500 cm(-1). The two peaks disappeared at malignant tissues. The intensity of the characteristic vibration peaks of normal tissues appearing at 3 062 and 1 003 cm(-1) corresponding to tyrosine weakened in malignant tissues. Thus, FT-Raman spectroscopy is a potential method in the diagnosis of hypothyroid cancer.

[The eyelid reconstruction in situ with allograft acellular dermal matrix].

OBJECTIVE: To explore the clinical value of allograft acellular dermal matrix in the treatment of eyelid defects. METHODS: From November 2001 to November 2002, 10 patients (8 male and 2 female; age varied from 14 to 47) with 11 eyelids were treated by eyelid reconstruction in situ with implantation of 1 mm thick allograft acellular dermal matrix. In 11 eyelids with defects, 2 was totally defect, 8 was 2/3 defect, 1 was 1/3 defect. In these 10 patients, 9 were injured and 1 was congenital. These defective eyelids included 8 upper lids, 1 lower lid and 1 case with both upper and lower lids. The average follow-up time was 8 months. RESULTS: In the follow-up periods, the inflammation of the eyelid was slight and no implants shedding or infection happened postoperatively. The conjunctiva grew well on the surface of the acellular dermal matrix. Histology examination showed neovascularization and presence of fibroblasts in the acellular dermal matrix 6 months after the operation. By the end of the follow up period, the results were excellent in 8 eyelids, good in 2 eyelids and improved in 1 eyelid. The efficacy rate of this treatment was 91%. CONCLUSIONS: Acellular dermal matrix can be used as a substitute of the tarsus in supporting the eyelid, it invokes little immunological and inflammatory reaction, and therefore, it can act as a biological scaffold to guide the growth of collagen and neovascularization.