Aim: This study aimed to investigate the mechanism of SSD in rats with Collagen- Induced Arthritis (CIA). Background: Rheumatoid arthritis (RA) is a complex immune disease characterized by bilateral symmetrical multi-joint pain and swelling. Si Shen Decoction (SSD) has shown good results in treating RA in clinical applications, but its mechanism of action remains unclear. Objective: To investigate the mechanism of SSD in rats with Collagen-Induced Arthritis (CIA). Methods: Bioinformatics and network pharmacology analyses were used to predict the possible treatment targets and signaling pathways. Elisa, Western blotting, and quantitative real-time polymerase chain reaction were used to verify the mechanism of SSD in the treatment of RA. Results: FABP4, MMP9, and PTGS2 were the most common predicted therapeutic targets. SSD treatment significantly reduced synovitis, ankle swelling and bone erosion in CIA rats. The SSD group also significantly reduced the serum secretion of CRP, TNFα, and IL1β, decreased mRNA levels of FABP4, IKKα, and p65 in the synovial membrane, but increased PPARγ. Western blot showed that SSD treatment could significantly reduce the expression of FABP4, IKKα, and phosphorylated p65 (p-p65) proteins in the synovium. SSD was found to inhibit the FABP4/PPARγ/NFκB signaling pathway and reduce the inflammatory response in CIA rats. The therapeutic effect of SSD was significant with the increase of dose. Conclusion: SSD can relieve joint symptoms in CIA rats and alleviate inflammation by inhibiting the FABP4/PPARγ/NFκB signaling pathway. The effect of high-dose SSD was more prominent.
Here we report on a case of a 61-year-old female patient with 7-year history of major depressive disorder with shorter-duration hypomanic episodes who was prescribed with antidepressants which turned out to be ineffective. After a COVID-19 infection, the patient's clinical presentation became sufficient for the diagnosis of bipolar disorder and she was consistently effective on a mood stabilizer and an atypical antipsychotic. The course of treatment in this case suggests bipolar disorder is not a binary disorder, but a continuous spectrum disorder. For patients suffering from major depressive disorder with shorter-duration hypomanic episodes, mood stabilizers and atypical antipsychotics are possibly more suitable than antidepressants.
Here we report on a case of a 40-year-old female patient who presented with hypomanic episode after hyperthyroidism and major depressive episode after hypothyroidism, which was initially misdiagnosed as bipolar disorder due to another medical condition, and was found to be a co-morbid bipolar disorder of hyperthyroidism after treatment and follow-up. The course of diagnosis and treatment in this case suggests a close temporal relationship does not necessarily mean that there is a causal relationship on a physiologic level. User's Guide for the SCID-5-CV Structured Clinical Interview for DSM-5 Disorders elaborate that the diagnosis of "……due to another medical condition" is relatively rare, and co-morbidity between psychiatric disorders and somatic diseases is much more common. Therefore, the relationship between somatic diseases and psychiatric disorders requires careful study of symptom correlation and more time for observational follow-up. When in doubt, the examiner's default assumption should be that the somatic disease is not the cause (i.e., the psychiatric disorder is primary).
Background: Major Depressive Disorder (MDD) is common and disabling, but its neural pathophysiology remains unclear. Functional brain network studies in MDD have largely had limited statistical power and data analysis approaches have varied widely. The REST-meta-MDD Project of resting-state fMRI (R-fMRI) addresses these issues.
Major Depressive Disorder (MDD) is one of the most common and disabling psychiatric disorders, but its neural pathophysiology remains largely unknown. Functional brain network studies in MDD have suffered from limited statistical power and high flexibility in data analyses. Here we launched the REST-meta-MDD Project of resting-state fMRI (R-fMRI) data of 1,300 patients with MDD and 1,128 normal controls (NCs) from 25 research groups in China. The data were preprocessed with a standardized protocol across all sites prior to aggregated group analyses. Our analyses focused on functional connectivity (FC) within the default mode network (DMN) which has been frequently reported to show increased FC in MDD. However, we found decreased instead of increased DMN FC in MDD compared to NCs. Specifically, this FC reduction only presented in recurrent MDD but not in first-episode drug naive MDD. Patients with recurrent MDD even demonstrated decreases of DMN FC when directly compared with the first-episode drug naive MDD. Decreased DMN FC was associated with medication usage in MDD but not illness duration or severity. Finally, exploratory analyses revealed alterations of local intrinsic activity in the MDD samples. The pooled R-fMRI metrics of the REST-meta-MDD Project provide an unprecedented opportunity to investigate the key neural underpinnings of MDD and call for longitudinal brain imaging studies to understand the effects of medications, illness duration and severity.
Abstract Background Patients with chronic rhinosinusitis (CRS) have a high incidence rate of anxiety and depression. However, changes in anxiety and depression with different severities of CRS,and the effects of symptoms and anatomical factors on the anxiety and depression of CRS patients remain unclear. Methods A total of 112 patients were enrolled in the study. The Sino-Nasal Outcome Test-20 (SNOT-22) score, Lund-Mackay scale and Lund-Kennedy scale were used to assess the severity of CRS, and the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression in patients. Results In the univariate analysis, SNOT-20 scores, nasal symptom scores, facial/ear symptom scores and sleep scores are significantly positively correlated with patients’ GAD-7 scores (all P <0.05); the patients’ SNOT-20 scores, nasal symptom scores, facial/ear symptom scores, sleep scores, and the higher side of the anterior ethmoid sinus and frontal sinus Lund-Mackay scores were significantly positively correlated with the patients’ PHQ-9 scores (all P <0.05). In a multivariate linear regression model, however, none of the covariates were found to be statistically associated with GAD-7. Another multivariate model indicated associations among the SNOT-20 sleep domain scores, the higher side of frontal sinus Lund- Mackay scores and PHQ-9 scores (both P < 0.01). Conclusions Exacerbated nasal and facial/ear symptoms, sleep dysfunction increase patients’ depression and anxiety. Lesions of the frontal sinus and anterior ethmoid sinus may be related to patients' depression. Treatment should be tailored to patients with these symptoms.
The presence of organic compounds in the waste liquor is of serious environmental concern that has plagued the development of alumina industry (Bayer Process). The present work attempts to develop a green and efficient process for removal of organics utilizing combined effect of sonolysis and ozonation (US/O3). The effects of reaction duration, ozone concentration and ultrasonic power are assessed for sonolysis (US), ozonation (O3) and combination of sonolysis and ozonation (US/O3). The optimal conditions for US/O3 treatment system is identified to be a reaction duration of 7 h, ozone concentration of 7.65 g/h, and ultrasonic power of 600 W. The total organic carbon (TOC) removal and decolorization are 60.13% and 87.1%, respectively. The process can be scaled-up to industrial scale, which could potentially serve to be a convenient, safe and sustainable alternative to the exisiting treatment technologies. Additionally, the treated waste water can be reused contributing to an improvement in the overall economics.
Abstract Suicidal behavior is a major concern for patients who suffer from major depressive disorder (MDD). However, dynamic alterations and dysfunction of resting-state networks (RSNs) in MDD patients with suicidality have remained unclear. Thus, we investigated whether subjects with different severity of suicidal ideation and suicidal behavior may have different disturbances in brain RSNs and whether these changes could be used as the diagnostic biomarkers to discriminate MDD with or without suicidal ideation and suicidal behavior. Then a multicenter, cross-sectional study of 528 MDD patients with or without suicidality and 998 healthy controls was performed. We defined the probability of dying by the suicide of the suicidality components as a ‘suicidality gradient’. We constructed ten RSNs, including default mode (DMN), subcortical (SUB), ventral attention (VAN), and visual network (VIS). The network connections of RSNs were analyzed among MDD patients with different suicidality gradients and healthy controls using ANCOVA, chi-squared tests, and network-based statistical analysis. And support vector machine (SVM) model was designed to distinguish patients with mild-to-severe suicidal ideation, and suicidal behavior. We found the following abnormalities with increasing suicidality gradient in MDD patients: within-network connectivity values initially increased and then decreased, and one-versus-other network values decreased first and then increased. Besides, within- and between-network connectivity values of the various suicidality gradients are mainly negatively correlated with HAMD anxiety and positively correlated with weight. We found that VIS and DMN-VIS values were affected by age ( p < 0.05), cingulo-opercular network, and SUB-VAN values were statistically influenced by sex ( p < 0.05). Furthermore, the SVM model could distinguish MDD patients with different suicidality gradients (AUC range, 0.73–0.99). In conclusion, we have identified that disrupted brain connections were present in MDD patients with different suicidality gradient. These findings provided useful information about the pathophysiological mechanisms of MDD patients with suicidality.
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