Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994-2015.

BACKGROUND: Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. METHODS: Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions. RESULTS: The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty. CONCLUSIONS: This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.

[Study on molecular mechanism of Solanum nigrum in treatment of hepatocarcinoma based on network pharmacology and molecular docking].

This study aimed to explore the main active ingredients and potential targets of Solanum nigrum(SN), so as to reveal the potential molecular mechanism of SN in the treatment of hepatocellular carcinoma(HCC) based on network pharmacology and molecular docking. First,the main active ingredients and predictive targets of SN were collected in the traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP). Then,the targets relating to HCC were collected through retrieval of integrated bio-pharmacological network database for traditional Korean medicine(PharmDB-K), oncogenomic database of hepatocellular carcinoma(OncoDB.hcc). The common targets of disease-drug component were selected through intersection between predictive targets and disease targets. Next, based on the String platform, protein-protein interaction network(PPI) model of the potential anti-HCC targets was constructed using the software Cytoscape 3.7.1. ClueGO and CluePedia APP in Cytoscape were used to analyze the gene function of SN in the treatment of HCC, and construct the main active ingredients-potential targets-signal pathways topology network of SN. Finally,DISCOVERY STUDIO software was applied in verifying the molecular docking between the key active ingredient and potential protein target. The results showed that there were 4 main active ingredients of SN, involving 22 potential targets relating to HCC and 7 signal pathways relating to potential anti-HCC targets of SN. Network analysis showed that SN may play a therapeutic role in HCC by acting on key targets, such as EGFR, TP53, MYC, CCND1 and CTNNB1. Molecular docking results showed that quercetin and EGFR could bind stably and interact through amino acid residues LEU718, LYS745 and GLN791. This study revealed the potential active ingredients and the possible molecular mechanism of SN for treatment of HCC, providing scientific basis for follow-up exploration of the molecular mechanism of SN against HCC.

In a Rat Model of Acute Liver Failure, Icaritin Improved the Therapeutic Effect of Mesenchymal Stem Cells by Activation of the Hepatocyte Growth Factor/c-Met Pathway.

Acute liver failure (ALF) is a serious life-threatening condition. Mesenchymal stem cells (MSCs) may be an effective treatment for this condition and a good alternative to liver transplantation. Icaritin (ICT) is an active ingredient of the genus Epimedium, a traditional Chinese medicine, with the potential to enhance the proliferation of MSCs. The purpose of this study was to explore whether ICT increased the therapeutic effects of MSCs and explore its underlying mechanisms. For in vivo experiments, a rat ALF model was established by intraperitoneal injection of D(+)-galactosamine/ lipopolysaccharide. MSCs cocultured with ICT were used to treat ALF rats and the protective effects assessed as survival rate, levels of serum AST and ALT, and histological changes in liver tissue. For in vitro experiments, MSCs were treated in serum-free culture for 72 h to simulate the disruption of intrahepatic microcirculation. MSCs apoptosis was examined to determine whether ICT rescued impaired MSCs. The role of the hepatocyte growth factor (HGF)/c-Met pathway in MSCs was assessed by constructing genetically modified MSCs overexpressing c-Met and by using the c-Met receptor inhibitor (crizotinib). The results showed that MSCs increased the survival rate of ALF rats and reduced liver damage. MSCs cocultured with ICT exerted a greater therapeutic effect than MSCs alone. Further, the HGF/c-Met pathway played a key role in the antiapoptotic activity of MSCs, which was associated with the optimized efficacy of ICT. In conclusion, this study demonstrated that ICT enhances the therapeutic effect of MSCs in a model of ALF, improving the antiapoptotic potential of MSCs by upregulation of the HGF/c-Met pathway. The combination of stem cell therapy with traditional herbal extracts may improve MSC-based clinical applications.

[Cognitive Impairments and Associated Factors in Community-dwelling Elderly in Chengdu, Sichuan].

OBJECTIVE: To determine the prevalence and associated factors of cognitive impairments in the community-dwelling elderly aged 60 years or older in Chengdu of Sichuan province. METHODS: A random cluster sampling strategy was adopted to select 621 community-dwelling elderly. Face-to-face interviews were conducted to assess the cognitive status of the participants. 2 tests and logistic regression analyses were performed to identify factors associated with cognitive impairments. RESULTS: About 40.9% of the participants had cognitive impairments. Those attended primary schools had a lower risk of cognitive impairments [odds ratio OR)=0.369, P<0.001] compared with the illiterate ones. Older age OR=1.505 for 70-79 years, P=0.042; OR=3.069 for ≥80 years, P<0.001), cerebrovascular disease OR=2.159, P=0.003) and smoking OR=2.388, P<0.001) were risk factors of cognitive impairments. Men had lower risk OR=0.489, P=0.005) of cognitive impairments than women. CONCLUSION: The prevalence of cognitive impairments in community-dwelling elderly in Chengdu is high in comparison with those in other cities. Illiteracy, older age (over 70 years), women, smoking, and cerebrovascular disease are risk factors of cognitive impairments.

IGF-1 defends against chronic-stress induced depression in rat models of chronic unpredictable mild stress through the PI3K/Akt/FoxO3a pathway.

This study aims to investigate the role of IGF-1 in chronic-stress induced depression through the PI3K/Akt/FoxO3a pathway. A rat model of chronic unpredictable mild stress (CUMS) was established. In total, 48 rats were randomized into control (normal rats), CUMS (CUMS modeled rats) and CUMS + IGF-1 (injection of IGF-1 before CUMS modeling) groups. Body weight, horizontal (number of horizontal crossing) and vertical activity (rearing times), and sucrose consumption were identified one day before and after the open-field test. The mRNA and protein expression of PI3K, Akt, FoxO3a and Bim in the hippocampus was measured by RT-qPCR and Western blotting, respectively. Compared with the control group, a lower body weight, a decreased number of horizontal crossings, reduced rearing times and lower sucrose consumption were observed in the CUMS and CUMS + IGF-1 groups after the test. However, a higher body weight, number of horizontal crossings, rearing times and sucrose consumption were found in the CUMS + IGF-1 group than those in the CUMS group. Compared with the control group, mRNA and protein expression of PI3K, Akt and FoxO3a was decreased, and Bim mRNA and protein expression was increased in the CUMS + IGF-1 and CUMS groups. Meanwhile, in comparison to the CUMS group, mRNA and protein expression of PI3K, Akt and FoxO3a was elevated, and Bim mRNA and protein expression was reduced in the CUMS + IGF-1 group. The results suggested that IGF-1 exerted an antidepressant-like effect on chronic-stress induced depression through the PI3K/Akt/FoxO3a pathway.

MicroRNA-451a, microRNA-34a-5p, and microRNA-221-3p as predictors of response to antidepressant treatment.

Aberrant expression of microRNAs (miRNAs) has been shown to be involved in early observations of depression. The aim of this study was to determine if serum levels of miRNA-451a, miRNA-34a-5p, and miRNA-221-3p can serve as indicators of disease progression or therapeutic efficacy in depression. We collected data from 84 depressed patients and 78 control volunteers recruited from the medical staff at the West China Hospital. Depression severity was rated using the 24-item Hamilton Depression Scale (HAMD). Serum miRNA-451a, miRNA-34a-5p, and miRNA-221-3p levels were determined in samples from the depressed patients before and 8 weeks after antidepressant treatment as well as in samples from controls. Compared with the controls, the patients had lower miRNA-451a levels, higher miRNA-34a-5p and miRNA-221-3p levels, and increased HAMD scores whether they underwent antidepressant treatment or not. Eight weeks after antidepressant treatment, the patients exhibited increased miRNA-451a levels, decreased miRNA-34a-5p and miRNA-221-3p levels, and reduced HAMD scores. The serum level of miRNA-451a was negatively correlated with HAMD scores of the patients, while the serum levels of miRNA-34a-5p and miRNA-221-3p were positively correlated with HAMD scores whether the patients underwent antidepressant treatment or not. Paroxetine was markedly effective in 50 patients who also displayed an increased level of miRNA-451a but reduced levels of miRNA-34a-5p and miRNA-221-3p. In contrast, paroxetine was moderately effective or ineffective in 34 patients. In conclusion, depressed patients had lower serum miRNA-451a but higher serum miRNA-34a-5p and miRNA-221-3p, and these miRNAs are potential predictors of the efficacy of antidepressants.

Internalized stigma in people with severe mental illness in rural China.

BACKGROUND: It is unknown whether there are differences in self-stigma among persons with different types of severe mental illness (SMI) in rural communities. AIM: This study was to examine the differences of self-stigma and its correlates in persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community in China. METHODS: A total of 453 persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community participated in the study. The Internalized Stigma of Mental Illness (ISMI) was used to measure self-stigma. The t-test and analyses of variance (ANOVA) were used to examine the differences in mean scores of ISMI and subscales among the three diagnoses. Logistic regression was used to explore the contributing factors to the level of self-stigma among the three groups. RESULTS: Self-stigma was moderate and severe with 94.7% of the total sample. Persons with schizophrenia had significantly higher mean scores of total ISMI, alienation and discrimination experience than those with bipolar disorders. Lower family income was significantly associated with higher levels of self-stigma in persons with schizophrenia and major depressive disorder. Factors predicting the level of self-stigma among the three groups were various. CONCLUSION: Self-stigma is common and severe in persons with schizophrenia, major depressive disorder and bipolar disorder, especially those with lower income status in rural community in China. Persons with schizophrenia may have higher levels of self-stigma than those with bipolar disorder. Individual-level interventions should be developed to reduce self-stigma among persons with SMI in Chinese rural communities.

MicroRNA-451a, microRNA-34a-5p, and microRNA-221-3p as predictors of response to antidepressant treatment

Aberrant expression of microRNAs (miRNAs) has been shown to be involved in early observations of depression. The aim of this study was to determine if serum levels of miRNA-451a, miRNA-34a-5p, and miRNA-221-3p can serve as indicators of disease progression or therapeutic efficacy in depression. We collected data from 84 depressed patients and 78 control volunteers recruited from the medical staff at the West China Hospital. Depression severity was rated using the 24-item Hamilton Depression Scale (HAMD). Serum miRNA-451a, miRNA-34a-5p, and miRNA-221-3p levels were determined in samples from the depressed patients before and 8 weeks after antidepressant treatment as well as in samples from controls. Compared with the controls, the patients had lower miRNA-451a levels, higher miRNA-34a-5p and miRNA-221-3p levels, and increased HAMD scores whether they underwent antidepressant treatment or not. Eight weeks after antidepressant treatment, the patients exhibited increased miRNA-451a levels, decreased miRNA-34a-5p and miRNA-221-3p levels, and reduced HAMD scores. The serum level of miRNA-451a was negatively correlated with HAMD scores of the patients, while the serum levels of miRNA-34a-5p and miRNA-221-3p were positively correlated with HAMD scores whether the patients underwent antidepressant treatment or not. Paroxetine was markedly effective in 50 patients who also displayed an increased level of miRNA-451a but reduced levels of miRNA-34a-5p and miRNA-221-3p. In contrast, paroxetine was moderately effective or ineffective in 34 patients. In conclusion, depressed patients had lower serum miRNA-451a but higher serum miRNA-34a-5p and miRNA-221-3p, and these miRNAs are potential predictors of the efficacy of antidepressants.

[Prevalence of Cognitive Impairments and Its Determinants in Rural Elderly in Sichuan Province].

OBJECTIVE: To determine the prevalence of cognitive impairment and its influencing factors in rural elderly in Sichuan Province. METHODS: A multi-stage random sampling method was adopted to select participants in six towns and eighteen administrative villages in Fushun and Lizhou. The cognitive functions of 1 065 rural elderly were assessed. Factors associated with cognitive impairments of the rural elderly were identified. RESULTS: About 39. 9% of the rural elderly had cognitive impairments. Gender, age, marital status, educational attainment, regular physical activities, quality of life and social support were associated with cognitive impairments. CONCLUSION: The prevalence of cognitive impairments in rural elderly in Sichuan is high in comparison with national and international averages. Targeted interventions are needed based on the identified influencing factors.

[Mental Disorders in Psychiatric Emergency Services of a General Hospital].

OBJECTIVE: To investigate the distribution, diagnosis and treatment of patients with mental disorders in emergency department of a large general hospital. METHODS: Records of patients with mental disorders, who came for psychiatric diagnosis in the emergency department of West China Hospital of Sichuan University, during 1 July 2014 to 30 June 2015 were reviewed. Data about demographic characteristics, diagnosis and treatment of those patients were extracted and analyzed. RESULTS: A total of 520 patients were included in the analysis: 212 male (40.8%) and 308 female (59.2%). Three most common disorders were "Schizophrenia, Schizotypal disorder and Delusional disorder" (175 cases, 33.7%), "Mood disorder" (106 cases, 20.4%) and "Neurosis, Stress related and Somatoform disorder" (113, 21.7%). 50 (9.6%) patients were not confirmed with a diagnosis. CONCLUSION: Common mental disorders in the emergency service of this hospital include "Schizophrenia, Schizotypal disorder and Delusional disorder", "Mood disorder", and "Neurosis, Stress related and Somatoform disorder". Diagnosis of some patients is unclear. A wide range of treatment regimen should be made available.

[Factors and validity analysis of Mini-Mental State Examination in Chinese elderly people].

OBJECTIVE: To examine factors that may have impact on the Mini-Mental State Examination (MMSE) screening validity, which could lead to further establishing the general model of the MMSE score in Chinese health elderly and to improve the screening accuracy of the existing MMSE reference. METHODS: Based on the data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the MMSE scores of 19,117 normal elderly and 137 dementia patients who met the inclusion criteria were used for the analysis. The area under the curve (AUC) and validity indexes were used to compare the screening accuracy of various criteria. Multiple linear regression was used to identify factors that had impact on the MMSE score for both the normal and dementia elderly. Descriptive analysis was performed for differences in the MMSE scores by age trends and gender between the normal and dementia elderly. RESULTS: The AUC of MMSE was ≥0.75(P<0.05). The MMSE score of the normal elderly declined nonlinearly as the age grew older(male: R2=0.924, P<0.05; female: R2=0.951, P<0.05), and increased nonlinearly as the education level rose(male: R2=0.948, P<0.05; female: R2=0.859, P< 0.05). The females had significantly lower MMSE scores than the males, with a faster decline trend with age than the males (95%CI of female partial regression coefficient was not overlapped with 95%CI of male partial regression coefficient). The dementia elderly showed a much lower MMSE score (male: difference of Z score:-1.573, P<0.05; female: difference of Z score:-1.222, P<0.05) and tended to with a faster decline speed than that of the normal elderly (95%CI of dementia partial regression coefficient included 95%CI of normal partial regression coefficient). CONCLUSION: The screening validity of MMSE in CLHLS is not affected by educational level. The analysis of factors that may impact on the MMSE screening validity are gender, age, vision and residence which with validity identification. These four factors can be used as assist tool of MMSE in the screening of dementia to improve the screening accuracy.

Altered functional connectivity in the brain default-mode network of earthquake survivors persists after 2 years despite recovery from anxiety symptoms.

Although acute impact of traumatic experiences on brain function in disaster survivors is similar to that observed in post-traumatic stress disorders (PTSD), little is known about the long-term impact of this experience. We have used structural and functional magnetic resonance imaging to investigate resting-state functional connectivity and gray and white matter (WM) changes occurring in the brains of healthy Wenchuan earthquake survivors both 3 weeks and 2 years after the disaster. Results show that while functional connectivity changes 3 weeks after the disaster involved both frontal-limbic-striatal and default-mode networks (DMN), at the 2-year follow-up only changes in the latter persisted, despite complete recovery from high initial levels of anxiety. No gray or WM volume changes were found at either time point. Taken together, our findings provide important new evidence that while altered functional connectivity in the frontal-limbic-striatal network may underlie the post-trauma anxiety experienced by survivors, parallel changes in the DMN persist despite the apparent absence of anxiety symptoms. This suggests that long-term changes occur in neural networks involved in core aspects of self-processing, cognitive and emotional functioning in disaster survivors which are independent of anxiety symptoms and which may also confer increased risk of subsequent development of PTSD.

Resting-state brain activation correlates with short-time antidepressant treatment outcome in drug-naïve patients with major depressive disorder.

OBJECTIVE: A resting-state functional magnetic resonance imaging study (fMRI) to investigate pretreatment regional differences in brain function, in patients with early treatment responsive (ERD) and early treatment nonresponsive (END) major depressive disorder (MDD). METHODS: Patients with MDD and healthy control subjects underwent fMRI. Intrinsic neural activity at baseline was evaluated via amplitude of low-frequency fluctuations (ALFF). Antidepressant treatment was initiated after MRI. All patients received selective serotonin reuptake inhibitor type antidepressants at the minimum effective dose. RESULTS: There were significant differences in brain activity between patients (n = 56) and control subjects (n = 33). Brain activity in patients with ERD (n = 26) differed from those with END (n = 30) in the lingual gyrus and cerebellum. There was a significantly correlation between activity in these regions and disease duration in patients with ERD, and with amelioration of depressive symptoms in patients with END. CONCLUSIONS: Brain regions related to the neural mechanism of MDD early treatment outcome were identified. These regions may have important implications for the treatment of MDD.

Impact of acute stress on human brain microstructure: An MR diffusion study of earthquake survivors.

A characterization of the impact of natural disasters on the brain of survivors is critical for a better understanding of posttraumatic responses and may inform the development of more effective early interventions. Here we report alterations in white matter microstructure in survivors soon after Wenchuan earthquake in China in 2008. Within 25 days after the Wenchuan earthquake, 44 healthy survivors were recruited and scanned on a 3T MR imaging system. The survivors were divided into two groups according to their self-rating anxiety scale (SAS) score, including the SAS(+) (SAS > 55 after correction) group and "SAS(-)" (SAS < 55 after correction) group. Thrity-two healthy volunteers were also recruited as control group before earthquake. Individual maps of fractional anisotropy (FA) were calculated and voxel-based analysis (VBA) was performed to allow the comparison between survivors and controls using ANCOVAs in SPM2. In addition, a correlation between SAS score and regional FA value was examined using Pearson's correlation analysis in SPSS 11.5. Compared with the healthy cohort, the whole group of 44 survivors showed significantly decreased FA values in the right prefrontal lobe, the parietal lobe, the basal ganglia, and the right parahippocampus. These effects did not appear to depend on self-rating anxiety. For the first time we provide evidence that acute trauma altered cerebral microstructure within the limbic system; furthermore, these alterations are evident shortly after the traumatic event, highlighting the need for early evaluation and intervention for trauma survivors.

[Clinical analysis of patients with acute and severe mental disorders complicated with hypokalemia].

OBJECTIVE: To study the occurrence and characteristics of hypokalemia to the patients with acute and severe mental disorders, and analyze its influencing factors. METHODS: There were 815 patients with actue and severe mental disorder admitted into our psychiatry department from June 2009 to May 2010, who all received the examination of potassium concentration routinely at the admission. The patients were divided into hypokalemia group and non-hypokalemia group, and the clinical information were surveyed and compared between the two groups to find out the influencing factors of hypokalemia. RESULTS: There were 177 patients with hypokalemia, and the proportion was 21.72%. Between the two groups, the difference of age, sex, admission season, whether with physical diseases and diagnosis were statistically significant (P < 0.05), while spiritual movement situation was not significant different (P > 0.05). Spearman rank correlation analysis showed that the incidence of hypokalemia was negatively correlated with age (r = -0.55, P = 0.00). Furthermore, multivariate analysis found that women, poor diet and physical disease were risk factors of hypolalemia (P < 0.05). CONCLUSION: There is relatively high probability of hypokalemia occurrence to the patients with acute and severe mental disorders, which should be distinguished and treated at the admission timely.

Voxelwise meta-analysis of gray matter reduction in major depressive disorder.

BACKGROUND: Voxel-based morphometry (VBM) has been widely used in studies of major depressive disorder (MDD) and has provided cumulative evidence of gray matter abnormalities in patients relative to controls. Thus we performed a meta-analysis to integrate the reported studies to determine the consistent gray matter alterations in MDD. METHODS: A systematic search was conducted to identify VBM studies which contrasted MDD patients against a comparison group. The coordinates of gray matter change across studies were meta-analyzed using the activation likelihood estimation (ALE) method hybridized with the rank-based Genome Scan Meta-Analysis (GSMA) to quantitatively estimate regional gray matter reductions in MDD. RESULTS: A total of 20 VBM studies comparing 543 major depressive patients with 750 healthy control subjects were included. Consistent gray matter reductions in all MDD patients relative to healthy controls were identified in the bilateral anterior cingulate cortex (ACC), right middle and inferior frontal gyrus, right hippocampus and left thalamus. CONCLUSIONS: Meta-analysis of all primary VBM studies indicates that significant gray matter reductions in MDD are localized in a distributed neural network which includes frontal, limbic and thalamic regions. Future studies will benefit from the use of a longitudinal approach to examine anatomical and functional abnormalities within this network and their relationship to clinical profile, particularly in first-episode and drug-naive MDD patients.

Abnormal regional spontaneous neural activity in treatment-refractory depression revealed by resting-state fMRI.

Treatment-refractory depression (TRD) represents a large proportion of the depressive population, yet has seldom been investigated using advanced imaging techniques. To characterize brain dysfunction in TRD, we performed resting-state functional MRI (rs-fMRI) on 22 TRD patients, along with 26 matched healthy subjects and 22 patients who were depressed but not treatment-refractory (NDD) as comparison groups. Results were analyzed using a data-driven approach known as Regional Homogeneity (ReHo) analysis which measures the synchronization of spontaneous fMRI signal oscillations within spatially neighboring voxels. Relative to healthy controls, both depressed groups showed high ReHo primarily within temporo-limbic structures, and more widespread low ReHo in frontal, parietal, posterior fusiform cortices, and caudate. TRD patients showed more cerebral regions with altered ReHo than did NDD. Moderate but significant correlations between the altered regional ReHo and measures of clinical severity were observed in some identified clusters. These findings shed light on the pathophysiological mechanisms underlying TRD and demonstrate the feasibility of using ReHo as a research and clinical tool to monitor persistent cerebral dysfunction in depression, although further work is necessary to compare different measures of brain function to elucidate the neural substrates of these ReHo abnormalities.

[A proton magnetic spectroscopy research on hippocampus metabolisms in people with suicide-attempted depressions].

OBJECTIVE: To investigate the metabolic features of hippocampus in people with suicide-attempted depressions. METHODS: Proton resonance spectroscopy (1H-MRS) was performed on the bilateral hippocampi of 24 patients with suicide-attempted depressions and 24 healthy people. The ratios of N-acetylasparte(NAA)/creatine (Cr), choline(Cho)/Cr and myoinositol(mI)/Cr were calculated and used as markers reflecting the metabolic levels of NAA, Cho and mI. The differences between the patients with suicide-attempted depressions and the healthy people were analyzed. The left hippocampus was also compared with the right to determine the asymmetry of the hippocampus metabolic. RESULTS: The ratio of NAA/Cr in the left hippocampus of the patients with suicide-attempted depressions was significantly less than that of the healthy control (P < 0.05). The ratio of NAA/Cr in the left hippocampus was significantly greater than in the right hippocampus of the healthy control (P < 0.05). However, the left-right deference of the ratio of NAA/Cr disappeared in the patients with suicide-attempted depressions. There was an asymmetry between the left and right hippocampi in the healthy people (P < 0.05), but not in the patients with suicide-attempted depressions (P > 0.05). No correlations between the metabolic markers and the course of disease, number of episodes and HAMD17 scores were found in the patients with suicide-attempted depressions (P > 0.05). CONCLUSION: There is a decrease of metabolite in the left hippocampus of patients with suicide-attempted depressions. The asymmetry of the bilateral hippocampi disappears in the patients with suicide-attempted depressions.

Magnetization transfer imaging reveals the brain deficit in patients with treatment-refractory depression.

BACKGROUND: Studies on treatment resistant depression (TRD) using advanced magnetic resonance imaging techniques are very limited. METHODS: A group of 15 patients with clinically defined TRD and 15 matched healthy controls underwent magnetization transfer imaging (MTI) and T1-weighted (T1W) imaging. MTI data were processed and analyzed voxel-wised in SPM2. A voxel based morphometric (VBM) analysis was performed using T1W images. RESULTS: Reduced magnetization transfer ratio was observed in the TRD group relative to normal controls in the anterior cingulate, insula, caudate tail and amygdala-parahippocampal areas. All these regions were identified within the right hemisphere. VBM revealed no morphological abnormalities in the TRD group compared to the control group. Negative correlations were found between MRI and clinical measures in the inferior temporal gyrus. LIMITATIONS: The cross-sectional design and small sample size. CONCLUSIONS: The findings suggest that MTI is capable of identifying subtle brain abnormalities which underlie TRD and in general more sensitive than morphological measures.

[Neuron apoptosis induced by 3,4-methylenedioxy methamphetamine and expression of apoptosis-related factors in rat brain].

OBJECTIVE: To study the neuron apoptosis induced by i.p 3,4-methylenedioxy methamphetamine (MDMA) and the expression of apoptosis-related factors in rat brain. METHODS: Twenty rats were divided into 4 groups. In group A, the rats were injected intraperitoneally with single dosage of saline, while the rats of group B, C, D were injected i.p with MDMA in different regimen, which were 20 mg/kg, single injection in group B, 20 mg/ kg twice a day (8 am and 8 pm), for 2 day in group C, as well as 20 mg/kg, twice a day (8 am and 8 pm) for 4 days. Neuron apoptosis were measured by TUNEL, and the expression of Caspase-3 and CytC were detected by immunohistochemistry. RESULTS: Compared with saline group, apoptosis neurons were detected at the related brain regions (such as frontal cortex, hippocampus and striatum) of the rats in MDMA treated groups; Expression of Caspase-3 and CytC was observed at different level. Compared with group B, the number of apoptosis neurons of group C and D increased, and also the apoptosis-related factors in the brain tissue increased (P < 0.05). CONCLUSION: MDMA could induce neurons apoptosis and the expression of apoptosis-related factors such as Caspase-3 and CytC in rat brain.