Objective:To investigate the clinical efficacy of acupuncture combined with emotional intervention in patients with post-stroke depression(PSD).Methods:A total of 100 patients with PSD who met the inclusion criteria w...Objective:To investigate the clinical efficacy of acupuncture combined with emotional intervention in patients with post-stroke depression(PSD).Methods:A total of 100 patients with PSD who met the inclusion criteria were randomly divided into an experimental group(50 cases)and a control group(50 cases)using the random number table method,and the enrollment was in order of admission time.The control group used conventional treatment of oral antidepressant Deanxit tablets(0.5 mg flupenthixol+10 mg melitracen)with the dose appropriately adjusted according to the patient’s medication effect,and modern rehabilitation treatment given selectively according to the patient’s condition.The experimental group had similar treatment as the control group with the addition of traditional Chinese medicine(TCM)acupuncture combined with emotional intervention.The application effects of both groups before and after treatment were verified using the Hamilton Depression Rating Scale(Ham-D),National Institutes of Health Stroke Scale(NIHSS),and Activities of Daily Living(ADL),serotonin levels were measured,and statistical analyses were carried out.Results:The total effective rate of patients in the experimental group was significantly higher than that in the control group,and the Ham-D score,NIHSS score,ADL score,and serotonin level after treatment were significantly higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:For patients with PSD,adding TCM acupuncture with emotional intervention on top of conventional treatment significantly improve the clinical efficacy and better improve the daily life ability of patients.展开更多
[Objectives]To observe the clinical effect of Huatanjieyu granule on patients with post-stroke depression.[Methods]Total 76 patients with confirmed post-stroke depression were randomly divided into two groups(treatmen...[Objectives]To observe the clinical effect of Huatanjieyu granule on patients with post-stroke depression.[Methods]Total 76 patients with confirmed post-stroke depression were randomly divided into two groups(treatment group and control group)according to the double-blind principle.The treatment group(38 cases)was treated with Huatanjieyu granule combined with escitalopram,and the control group(38 cases)was treated with escitalopram alone.The course of treatment was 6 weeks.Through clinical efficacy,Hamilton Depression Scale(HAMD)and Treatment Emergent Symptom Scale(TESS)scores were compared,and blood,liver function,renal function and electrocardiogram were examined.[Results]The scores of HAMD and TESS in patients with post-stroke depression were significantly decreased by Huatanjieyu granule,and there were no obvious side effects.The total effective rate was 92.1%in the treatment group and 76.3%in the control group.There was significant difference between the two groups(P<0.01).[Conclusions]Huatanjieyu granule was effective in the treatment of post-stroke depression with little side effects and was easy to be accepted by patients.展开更多
Post-stroke depression is an affective disorder that occurs after stroke.Its pathogenesis has not yet been fully understood,and it mainly involves neurobiology,neuroanatomy,and psychology.This paper provides an overvi...Post-stroke depression is an affective disorder that occurs after stroke.Its pathogenesis has not yet been fully understood,and it mainly involves neurobiology,neuroanatomy,and psychology.This paper provides an overview on the neurobiological mechanism of post-stroke depression to further understand post-stroke depression and to provide references for further research.展开更多
BACKGROUND: c-fos and c-jun, the important immediate early genes (IEG), are regarded as the markers for the location and function of neuronal activity, as well as the third signal messengers, they couple the stress st...BACKGROUND: c-fos and c-jun, the important immediate early genes (IEG), are regarded as the markers for the location and function of neuronal activity, as well as the third signal messengers, they couple the stress stimulation and the gene expression in neuron, and hippocampus is involved in the process of signal transmission after stress stimulation induced depression. OBJECTIVE: To observe the therapeutic effects of Bushen Yiqi (tonifying kidney to benefit qi), Huoxue Huayu (promoting blood circulation to dissipate blood stasis) and Ditan Kaiqiao (eliminating phlegm for resuscitation) on the expressions of c-Fos and c-Jun proteins in hippocampus and spontaneous behaviors of rats with post-stroke depression (PSD), and compare the results with those of fluoxetine, which is known to have definite effect on depression. DESIGN: A randomized controlled trial. SETTING: Zhejiang College of Traditional Chinese Medicine. MATERIALS: The trial was completed in Zhejiang College of Traditional Chinese Medicine from January to July in 2003. Fifty-six healthy adult Wistar male rats of clean grade, weighing (250±50) g, were randomly divided into 7 groups with 8 rats in each group: control group, model group, forced swimming group, Bushen Yiqi group; Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group. The Bushen Yiqi Tang contained Renshen, Huangqi, Heshouwu, Gouqi, Shudi, etc., crude drugs 1 800 g/L. The Huoxue Huayu Tang contained Danshen, Chuanxiong, Chishao, Yujin, etc., crude drugs 3 600 g/L. The Ditan Kaiqiao Tang contained Banxia, Danxing, Changpu, Yuanzhi, etc., crude drug 1 000 g/L. METHODS: ① Except the control group and forced swimming group, rats in the other groups were made into PSD models by deligating the bilateral common carotid arteries permanently. ② Rats in the control group, model group and forced swimming group were intragastrically perfused by saline (3 mL for each time); those in the Bushen Yiqi group, Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group were intragastrically perfused with Bushen Yiqi Tang (18 g/kg), Huoxue Huayu Tang (9 g/kg), Ditan Kaiqiao Tang (9 g/kg) and fluoxetine (2.5 mg/kg) respectively, once a day. ③ At 55 days after model establishment, rats in the forced swimming group were managed according to the Porsolt’s method. They were placed in water for 15 minutes, and then taken out and dried, no moving-time within 5 minutes was recorded at drying and 24 hours after drying. ④ Measurement of spontaneous behaviors: Except the forced swimming group, the spontaneous behaviors and activities (including horizontal and vertical movements) of rats were observed with the Open-Field method at 28, 42 and 56 days after administration in the other groups. ⑤ The expressions of c-Fos and c-Jun proteins in hippocampus were determined with the immunohistochemical method, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were measured with the computerized image analytical system. MAIN OUTCOME MEASURES: The spontaneous behaviors of rats, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were observed. RESULTS: Of the 56 rats, 1 died in the forced swimming group, and finally 55 rats were involved in the analysis of results. ① Results of spontaneous activities: At 28 days, the times of crossing movements were obviously fewer in the model group and fluoxetine group [(69.00±37.01), (98.11±36.68) times/3 minutes] than in the control group [(128.44±16.85) times/3 minutes, P < 0.01, 0.05], but those in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group had no obvious differences as compared with those in the control group (P > 0.05). At 42 and 56 days, the times of crossing movements were obviously more in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group [(106.44±31.24), (117.20±23.95), (134.80±28.18), (136.36±40.95) times/3 minutes; (117.33±35.91), (129.60±23.78), (131.90±26.81), (136.09±28.34) times/3 minutes] than in the model group [(64.00±17.51), (72.86±20.68) times/3 minutes, P < 0.01]. The times of rearing movements had no obvious differences among the groups for the three times (P > 0.05). ② The no moving-time within 5 minutes 24 hours after drying was obviously longer than that at drying in the forced swimming group. ③ The average objective gray values of c-Fos positive cells were not obviously different in the Bushen Yiqi group and Ditan Kaiqiao group from the control group (P > 0.05), but lower in the model group than in the control group (69.84±9.82, 75.78±5.89, P < 0.01), and higher in the forced swimming group than in the control group (85.97±10.99, P < 0.01); all higher in the fluoxetine group, Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (81.27±10.73, 74.04±8.34, 83.29±9.89, 70.14±4.92, P < 0.05-0.01). The average objective gray values of c-Jun positive cells were obviously lower in the Bushen Yiqi group than in the control group (68.11±6.89, 79.58±5.86, P < 0.01), but all higher in the other groups than in the control group (84.68±7.15, 81.34 ±8.36, 97.51±10.55, 85.68±9.25, 86.19±10.98, P < 0.05-0.01); Those were obviously higher in the fluoxetine group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (P < 0.05-0.01), lower in the Bushen Yiqi group than in the model group (P < 0.05), all obviously lower in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the fluoxetine group (P < 0.01). The relative sectional area ratios of c-Fos and c-Jun positive cells had no obvious differences among the groups (P > 0.05). CONCLUSION: The methods of Bushen Yiqi, Huoxue Quyu and Ditan Kaiqiao can effectively treat PSD in rats, and the results were equivalent with those of fluoxetine, the actions of the above-mentioned drugs may correlated with their regulation to c-Fos and c-Jun expressions in hippocampus. PSD animal models can be successfully established by both permanent deligation of bilateral common carotid arteries and forced swimming, and the models induced by the former has similar basic cerebrovascular lesions as human stroke in clinic.展开更多
Post-stroke depression (PSD) is one of the most common affective disorders after acute cerebrovascular injury. It significantly increases the mortality, disability rate and recurrence rate of stroke, which places a he...Post-stroke depression (PSD) is one of the most common affective disorders after acute cerebrovascular injury. It significantly increases the mortality, disability rate and recurrence rate of stroke, which places a heavy burden on families and society. The etiology of PSD is not yet clear, involving a series of complex mechanisms. Inflammatory response, apoptosis, neurotrophic factors, neurotransmitters and many others may play important roles, and there is no effective treatment. Salvianolic acid for injection (SAFI) has the functions of anti-inflammatory, anti-oxidative stress, anti-apoptotic and can improve depressive behavior. It is expected to become a new antidepressant for the treatment of PSD.展开更多
Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chine...Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chinese databases(Sinomed,CNKI,VIP,Wanfang),PubMed,Cochrane Library,and Web of Science were searched.Randomized controlled trials of patients with PSD treated with traditional Chinese medicine were included.Quality evaluation was performed and Meta-analysis was performed using RevMan 5.4 software.Results:The results show that TCM therapy is superior to western medicine in reducing the level of TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001],IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]and IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]in venous blood of PSD patients,and is superior to western medicine in reducing the score of HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]and NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001].The combination of Chinese medicine and western medicine is superior to western medicine in reducing the level of TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.0001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]and Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]in venous blood of patients with PSD,and is superior to western medicine in reducing the score of HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]and HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]and improving BI index.Three studies do not mention adverse reactions,and 37 cases in the remaining three studies show rash,tremor,dizziness and other adverse reactions.The incidence of adverse reactions in the experimental group was lower than that in the control group,and there were no serious adverse reactions.Conclusion:The results suggest that traditional Chinese medicine can reduce the level of some inflammatory factors in patients with PSD to a certain extent,and its efficacy is better than that of western medicine alone.Nevertheless,this study has some limitations,and with the increase of related trials in the future,the conclusions of the study need to be further discussed by adding more high-quality RCT studies.展开更多
Objective:To evaluate the relationship between post-stroke depression(PSD)and the risk of mortality in post stroke patients.Methods:Cohort studies related to PSD and risk of mortality were collected by searching PubMe...Objective:To evaluate the relationship between post-stroke depression(PSD)and the risk of mortality in post stroke patients.Methods:Cohort studies related to PSD and risk of mortality were collected by searching PubMed,Cochrane Library,EMBASE,WanFang Data,CNKI and VIP databases.The retrieval time limit was from the establishment of the database to January 2020.The meta-analysis was carried out by Using Stata software after two researchers independently selected literature,extracted data and evaluated the bias risk.Results:A total of 243826 participants were included in 12 studies.The combined results showed that PSD increased all-cause mortality in stroke patients[HR=1.51,95%CI(1.16,1.85),P<0.001].Subgroup analysis also showed that PSD significantly increased all-cause mortality in stroke patients during brief-term follow-up:[HR=1.45,95%CI(0.96,1.93),P<0.001]and long-term follow-up:[HR=1.51,95%CI(1.23,1.79),P<0.001].Conclusion:PSD can significantly increase the risk of mortality in post-stroke patients.Considering the limitation of potential heterogeneity,more high-quality literature studies are needed to verify.展开更多
Objective:To analyze the law of acupoint selection in treatment of depression after stroke by using data mining technique,providing reference for clinical treatment.Methods:Through the retrieval of CNKI,wanfang data r...Objective:To analyze the law of acupoint selection in treatment of depression after stroke by using data mining technique,providing reference for clinical treatment.Methods:Through the retrieval of CNKI,wanfang data resource system and Vip Database,relevant literature on acupuncture treatment of this disease in China from the inception of the database to 2019 were collected.Thus the database of acupoint prescriptions was established.SPSS20.0 and SPSS Modeler 18.0 software were used for statistical analysis to explore the law of acupoint selection.Results:A total of 92 articles were selected,92 acupuncture prescriptions and 88 acupoints with a total frequency of 715 times.The frequency of acupoints of Du channel ranked first.The frequency of acupoints in the head and neck and lower limbs were successively 40.42%(289/715)and 20.46%(172/715).Specific acupoints accounted for 81.82%of the acupoints used,among which confluent acupoints ranked first.The correlation analysis results showed that the highest support of acupoint combination was Baihui(GV20)and Shenting(GV24).Conclusion:The acupoint selection in the treatment of PSD gives priority to the Du channel,following the principle of local acupoint selection,local and remote acupoint selection with the precondition of regulation the mind.Attach importance to the use of specific acupoints,especially the confluent points.展开更多
The patients with post-stroke depression often form a negative evaluation of themselves,and even have the idea of suicide in serious cases.Therefore,post-stroke depression has become one of the most common complicatio...The patients with post-stroke depression often form a negative evaluation of themselves,and even have the idea of suicide in serious cases.Therefore,post-stroke depression has become one of the most common complications of mental illness after stroke,which seriously hinders the normal rehabilitation of the central nervous system,thus increasing the disability rate,early recurrence rate and mortality rate of patients.Therefore,the active treatment of post-stroke depression is very necessary.Western medicine uses antidepressant drugs for this kind of patients,but because the side effects of antidepressants are relatively large,the compliance of patients is not good,it is not easy to see the effect,while traditional Chinese medicine(TCM)has many ways to deal with post-stroke depression with obvious advantages,the side effects are relatively small,and there is more compliance in patients.This paper focuses on several TCM treatment methods,hoping to provide a reference for the treatment of post-stroke depression.展开更多
Post-stroke depression(PSD)is a serious and common complication of stroke,which seriously afects the rehabilitation of stroke patients.To date,the pathogenesis of PSD is unclear and efective treatments remain unavaila...Post-stroke depression(PSD)is a serious and common complication of stroke,which seriously afects the rehabilitation of stroke patients.To date,the pathogenesis of PSD is unclear and efective treatments remain unavailable.Here,we established a mouse model of PSD through photothrombosis-induced focal ischemia.By using a combination of brain imaging,transcriptome sequencing,and bioinformatics analysis,we found that the hippocampus of PSD mice had a signifcantly lower metabolic level than other brain regions.RNA sequencing revealed a signifcant reduction of miR34b-3p,which was expressed in hippocampal neurons and inhibited the translation of eukaryotic translation initiation factor 4E(eIF4E).Furthermore,silencing eIF4E inactivated microglia,inhibited neuroinfammation,and abolished the depression-like behaviors in PSD mice.Together,our data demonstrated that insufcient miR34b-3p after stroke cannot inhibit eIF4E translation,which causes PSD by the activation of microglia in the hippocampus.Therefore,miR34b-3p and eIF4E may serve as potential therapeutic targets for the treatment of PSD.展开更多
Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas ...Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas little attention was given to the affective deficits.Effective management of PSD,including diagnosis,intervention,and follow-ups,is essential for post-stroke rehabilitation.As an objective measurement of the nervous system,electroencephalography(EEG)has been applied to the diagnosis and evaluation of PSD.In this paper,we re-viewed the literature most related to the clinical applications of EEG for PSD and offered a cross-section that is useful for selecting appropriate approaches in practice.This study aimed to gather EEG-based empirical ev-idence for PSD diagnosis,review interventions for managing PSD,and analyze the evaluation approaches.In total,33 diagnostic studies and 19 intervention studies related to PSD and depression were selected from the literature.It was found that the EEG features analyzed by both band-based and nonlinear dynamic approaches were capable of quantifying the abnormal neural responses on the cortical level for PSD diagnosis and interven-tion evaluation/prediction.Meanwhile,EEG-based machine learning has also been applied to the diagnosis and evaluation of depression to automate and speed up the process,and the results have been promising.Although brain-computer interface(BCI)interventions have been widely applied to post-stroke motor rehabilitation and cognitive training,BCI emotional training has not been directly used in PSD yet.This review showed the need for understanding the cortical responses of PSD to improve its diagnosis and precision treatment.It also revealed that future post-stroke rehabilitation plans should include training sessions for motor,affect,and cognitive functions and closely monitor their improvements.展开更多
The articles on the pathogenesis of post-stroke depression(PSD)and the acupuncture treatment mechanism of PSD from January 2010 through to June 2020 were retrieved from China National knowledge Infrastructure(CNKI),Wa...The articles on the pathogenesis of post-stroke depression(PSD)and the acupuncture treatment mechanism of PSD from January 2010 through to June 2020 were retrieved from China National knowledge Infrastructure(CNKI),Wanfang Database,VIP China Science-Technology and National Social Sciences Database.In summary,the potential mechanism of acupuncture in treatment of PSD is explained from the following three aspects:acupuncture regulating monoamine neurotransmitters,acupuncture regulating neurotrophic factors and acupuncture regulating cytokines.The limitation and prospects of the current researches are also put forward so as to provide the references and to determine the research direction in the future.展开更多
基金The Shandong Traditional Chinese Medicine Science and Technology Development Program 2020Q132。
文摘Objective:To investigate the clinical efficacy of acupuncture combined with emotional intervention in patients with post-stroke depression(PSD).Methods:A total of 100 patients with PSD who met the inclusion criteria were randomly divided into an experimental group(50 cases)and a control group(50 cases)using the random number table method,and the enrollment was in order of admission time.The control group used conventional treatment of oral antidepressant Deanxit tablets(0.5 mg flupenthixol+10 mg melitracen)with the dose appropriately adjusted according to the patient’s medication effect,and modern rehabilitation treatment given selectively according to the patient’s condition.The experimental group had similar treatment as the control group with the addition of traditional Chinese medicine(TCM)acupuncture combined with emotional intervention.The application effects of both groups before and after treatment were verified using the Hamilton Depression Rating Scale(Ham-D),National Institutes of Health Stroke Scale(NIHSS),and Activities of Daily Living(ADL),serotonin levels were measured,and statistical analyses were carried out.Results:The total effective rate of patients in the experimental group was significantly higher than that in the control group,and the Ham-D score,NIHSS score,ADL score,and serotonin level after treatment were significantly higher than those in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:For patients with PSD,adding TCM acupuncture with emotional intervention on top of conventional treatment significantly improve the clinical efficacy and better improve the daily life ability of patients.
基金the Hospital-level Project of Shiyan Taihe Hospital in 2018(2018JJXM092)Shiyan Science and Technology Research and Development Project in 2018(18Y17).
文摘[Objectives]To observe the clinical effect of Huatanjieyu granule on patients with post-stroke depression.[Methods]Total 76 patients with confirmed post-stroke depression were randomly divided into two groups(treatment group and control group)according to the double-blind principle.The treatment group(38 cases)was treated with Huatanjieyu granule combined with escitalopram,and the control group(38 cases)was treated with escitalopram alone.The course of treatment was 6 weeks.Through clinical efficacy,Hamilton Depression Scale(HAMD)and Treatment Emergent Symptom Scale(TESS)scores were compared,and blood,liver function,renal function and electrocardiogram were examined.[Results]The scores of HAMD and TESS in patients with post-stroke depression were significantly decreased by Huatanjieyu granule,and there were no obvious side effects.The total effective rate was 92.1%in the treatment group and 76.3%in the control group.There was significant difference between the two groups(P<0.01).[Conclusions]Huatanjieyu granule was effective in the treatment of post-stroke depression with little side effects and was easy to be accepted by patients.
文摘Post-stroke depression is an affective disorder that occurs after stroke.Its pathogenesis has not yet been fully understood,and it mainly involves neurobiology,neuroanatomy,and psychology.This paper provides an overview on the neurobiological mechanism of post-stroke depression to further understand post-stroke depression and to provide references for further research.
基金a grant from Hy-giene Fund of ZhejiangProvince, No. 2000A015
文摘BACKGROUND: c-fos and c-jun, the important immediate early genes (IEG), are regarded as the markers for the location and function of neuronal activity, as well as the third signal messengers, they couple the stress stimulation and the gene expression in neuron, and hippocampus is involved in the process of signal transmission after stress stimulation induced depression. OBJECTIVE: To observe the therapeutic effects of Bushen Yiqi (tonifying kidney to benefit qi), Huoxue Huayu (promoting blood circulation to dissipate blood stasis) and Ditan Kaiqiao (eliminating phlegm for resuscitation) on the expressions of c-Fos and c-Jun proteins in hippocampus and spontaneous behaviors of rats with post-stroke depression (PSD), and compare the results with those of fluoxetine, which is known to have definite effect on depression. DESIGN: A randomized controlled trial. SETTING: Zhejiang College of Traditional Chinese Medicine. MATERIALS: The trial was completed in Zhejiang College of Traditional Chinese Medicine from January to July in 2003. Fifty-six healthy adult Wistar male rats of clean grade, weighing (250±50) g, were randomly divided into 7 groups with 8 rats in each group: control group, model group, forced swimming group, Bushen Yiqi group; Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group. The Bushen Yiqi Tang contained Renshen, Huangqi, Heshouwu, Gouqi, Shudi, etc., crude drugs 1 800 g/L. The Huoxue Huayu Tang contained Danshen, Chuanxiong, Chishao, Yujin, etc., crude drugs 3 600 g/L. The Ditan Kaiqiao Tang contained Banxia, Danxing, Changpu, Yuanzhi, etc., crude drug 1 000 g/L. METHODS: ① Except the control group and forced swimming group, rats in the other groups were made into PSD models by deligating the bilateral common carotid arteries permanently. ② Rats in the control group, model group and forced swimming group were intragastrically perfused by saline (3 mL for each time); those in the Bushen Yiqi group, Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group were intragastrically perfused with Bushen Yiqi Tang (18 g/kg), Huoxue Huayu Tang (9 g/kg), Ditan Kaiqiao Tang (9 g/kg) and fluoxetine (2.5 mg/kg) respectively, once a day. ③ At 55 days after model establishment, rats in the forced swimming group were managed according to the Porsolt’s method. They were placed in water for 15 minutes, and then taken out and dried, no moving-time within 5 minutes was recorded at drying and 24 hours after drying. ④ Measurement of spontaneous behaviors: Except the forced swimming group, the spontaneous behaviors and activities (including horizontal and vertical movements) of rats were observed with the Open-Field method at 28, 42 and 56 days after administration in the other groups. ⑤ The expressions of c-Fos and c-Jun proteins in hippocampus were determined with the immunohistochemical method, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were measured with the computerized image analytical system. MAIN OUTCOME MEASURES: The spontaneous behaviors of rats, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were observed. RESULTS: Of the 56 rats, 1 died in the forced swimming group, and finally 55 rats were involved in the analysis of results. ① Results of spontaneous activities: At 28 days, the times of crossing movements were obviously fewer in the model group and fluoxetine group [(69.00±37.01), (98.11±36.68) times/3 minutes] than in the control group [(128.44±16.85) times/3 minutes, P < 0.01, 0.05], but those in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group had no obvious differences as compared with those in the control group (P > 0.05). At 42 and 56 days, the times of crossing movements were obviously more in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group [(106.44±31.24), (117.20±23.95), (134.80±28.18), (136.36±40.95) times/3 minutes; (117.33±35.91), (129.60±23.78), (131.90±26.81), (136.09±28.34) times/3 minutes] than in the model group [(64.00±17.51), (72.86±20.68) times/3 minutes, P < 0.01]. The times of rearing movements had no obvious differences among the groups for the three times (P > 0.05). ② The no moving-time within 5 minutes 24 hours after drying was obviously longer than that at drying in the forced swimming group. ③ The average objective gray values of c-Fos positive cells were not obviously different in the Bushen Yiqi group and Ditan Kaiqiao group from the control group (P > 0.05), but lower in the model group than in the control group (69.84±9.82, 75.78±5.89, P < 0.01), and higher in the forced swimming group than in the control group (85.97±10.99, P < 0.01); all higher in the fluoxetine group, Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (81.27±10.73, 74.04±8.34, 83.29±9.89, 70.14±4.92, P < 0.05-0.01). The average objective gray values of c-Jun positive cells were obviously lower in the Bushen Yiqi group than in the control group (68.11±6.89, 79.58±5.86, P < 0.01), but all higher in the other groups than in the control group (84.68±7.15, 81.34 ±8.36, 97.51±10.55, 85.68±9.25, 86.19±10.98, P < 0.05-0.01); Those were obviously higher in the fluoxetine group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group (P < 0.05-0.01), lower in the Bushen Yiqi group than in the model group (P < 0.05), all obviously lower in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the fluoxetine group (P < 0.01). The relative sectional area ratios of c-Fos and c-Jun positive cells had no obvious differences among the groups (P > 0.05). CONCLUSION: The methods of Bushen Yiqi, Huoxue Quyu and Ditan Kaiqiao can effectively treat PSD in rats, and the results were equivalent with those of fluoxetine, the actions of the above-mentioned drugs may correlated with their regulation to c-Fos and c-Jun expressions in hippocampus. PSD animal models can be successfully established by both permanent deligation of bilateral common carotid arteries and forced swimming, and the models induced by the former has similar basic cerebrovascular lesions as human stroke in clinic.
基金Natural Science Foundation of Shanxi Provinc(201801D121219)Shanxi Provincial Health and Family Planning Commission project(2017065)
文摘Post-stroke depression (PSD) is one of the most common affective disorders after acute cerebrovascular injury. It significantly increases the mortality, disability rate and recurrence rate of stroke, which places a heavy burden on families and society. The etiology of PSD is not yet clear, involving a series of complex mechanisms. Inflammatory response, apoptosis, neurotrophic factors, neurotransmitters and many others may play important roles, and there is no effective treatment. Salvianolic acid for injection (SAFI) has the functions of anti-inflammatory, anti-oxidative stress, anti-apoptotic and can improve depressive behavior. It is expected to become a new antidepressant for the treatment of PSD.
基金supported by Key Research Project of the University(No.2020-JYB-ZDGG-121)the National Natural Science Foundation of China(No.81874422)the Natural Science Foundation of Beijing,China(No.7202120)。
文摘Objective:To systematically evaluate the effect of traditional Chinese medicine on inflammatory factors in patients with post-stroke depression(PSD)and the efficacy of traditional Chinese medicine on PSD.Methods:Chinese databases(Sinomed,CNKI,VIP,Wanfang),PubMed,Cochrane Library,and Web of Science were searched.Randomized controlled trials of patients with PSD treated with traditional Chinese medicine were included.Quality evaluation was performed and Meta-analysis was performed using RevMan 5.4 software.Results:The results show that TCM therapy is superior to western medicine in reducing the level of TNF-α[MD=-4.13,95%CI(-4.75,-3.51),P<0.00001],IL-6[MD=-3.39,95%CI(-3.90,-2.88),P<0.00001]and IL-8[MD=-2.12,95%CI(-2.49,-1.75),P<0.00001]in venous blood of PSD patients,and is superior to western medicine in reducing the score of HAMD[MD=-4.22,95%CI(-5.37,-3.07),P<0.00001]and NIHSS[MD=-2.33,95%CI(-3.43,-1.23),P<0.0001].The combination of Chinese medicine and western medicine is superior to western medicine in reducing the level of TNF-α[MD=-10.61,95%CI(-15.30,-5.91),P<0.00001]、IL-1[MD=-3.75,95%CI(-4.51,-2.99),P<0.00001]、IL-6[MD=-3.83,95%CI(-4.49,-3.16),P<0.0001]、IL-8[MD=-9.41,95%CI(-14.89,-3.92),P<0.00001]and Hcy[MD=-3.81,95%CI(-4.62,-2.99),P<0.00001]in venous blood of patients with PSD,and is superior to western medicine in reducing the score of HAMD[MD=-3.06,95%CI(-3.39,-2.73),P<0.00001]、NIHSS[MD=-4.47,95%CI(-7.55,-1.39),P=0.004]and HAMA[MD=-2.83,95%CI(-3.47,-2.19),P<0.00001]and improving BI index.Three studies do not mention adverse reactions,and 37 cases in the remaining three studies show rash,tremor,dizziness and other adverse reactions.The incidence of adverse reactions in the experimental group was lower than that in the control group,and there were no serious adverse reactions.Conclusion:The results suggest that traditional Chinese medicine can reduce the level of some inflammatory factors in patients with PSD to a certain extent,and its efficacy is better than that of western medicine alone.Nevertheless,this study has some limitations,and with the increase of related trials in the future,the conclusions of the study need to be further discussed by adding more high-quality RCT studies.
基金Natural Science Foundation of Heilongjiang Province(H2018063)Natural Science Foundation of Heilongjiang Province(H2015033)+1 种基金Heilongjiang Traditional Chinese Medicine Research Project(21102190005)Project of Heilongjiang Administration of Traditional Chinese Medicine(ZHY12-2058)
文摘Objective:To evaluate the relationship between post-stroke depression(PSD)and the risk of mortality in post stroke patients.Methods:Cohort studies related to PSD and risk of mortality were collected by searching PubMed,Cochrane Library,EMBASE,WanFang Data,CNKI and VIP databases.The retrieval time limit was from the establishment of the database to January 2020.The meta-analysis was carried out by Using Stata software after two researchers independently selected literature,extracted data and evaluated the bias risk.Results:A total of 243826 participants were included in 12 studies.The combined results showed that PSD increased all-cause mortality in stroke patients[HR=1.51,95%CI(1.16,1.85),P<0.001].Subgroup analysis also showed that PSD significantly increased all-cause mortality in stroke patients during brief-term follow-up:[HR=1.45,95%CI(0.96,1.93),P<0.001]and long-term follow-up:[HR=1.51,95%CI(1.23,1.79),P<0.001].Conclusion:PSD can significantly increase the risk of mortality in post-stroke patients.Considering the limitation of potential heterogeneity,more high-quality literature studies are needed to verify.
文摘Objective:To analyze the law of acupoint selection in treatment of depression after stroke by using data mining technique,providing reference for clinical treatment.Methods:Through the retrieval of CNKI,wanfang data resource system and Vip Database,relevant literature on acupuncture treatment of this disease in China from the inception of the database to 2019 were collected.Thus the database of acupoint prescriptions was established.SPSS20.0 and SPSS Modeler 18.0 software were used for statistical analysis to explore the law of acupoint selection.Results:A total of 92 articles were selected,92 acupuncture prescriptions and 88 acupoints with a total frequency of 715 times.The frequency of acupoints of Du channel ranked first.The frequency of acupoints in the head and neck and lower limbs were successively 40.42%(289/715)and 20.46%(172/715).Specific acupoints accounted for 81.82%of the acupoints used,among which confluent acupoints ranked first.The correlation analysis results showed that the highest support of acupoint combination was Baihui(GV20)and Shenting(GV24).Conclusion:The acupoint selection in the treatment of PSD gives priority to the Du channel,following the principle of local acupoint selection,local and remote acupoint selection with the precondition of regulation the mind.Attach importance to the use of specific acupoints,especially the confluent points.
文摘The patients with post-stroke depression often form a negative evaluation of themselves,and even have the idea of suicide in serious cases.Therefore,post-stroke depression has become one of the most common complications of mental illness after stroke,which seriously hinders the normal rehabilitation of the central nervous system,thus increasing the disability rate,early recurrence rate and mortality rate of patients.Therefore,the active treatment of post-stroke depression is very necessary.Western medicine uses antidepressant drugs for this kind of patients,but because the side effects of antidepressants are relatively large,the compliance of patients is not good,it is not easy to see the effect,while traditional Chinese medicine(TCM)has many ways to deal with post-stroke depression with obvious advantages,the side effects are relatively small,and there is more compliance in patients.This paper focuses on several TCM treatment methods,hoping to provide a reference for the treatment of post-stroke depression.
基金supported by the National Natural Science Foundation of China(81870932,81571078,51627807,31721002,81920208014,31930051)China Postdoctoral Science Foundation Funded Project(2020M672324,2020TQ0113).
文摘Post-stroke depression(PSD)is a serious and common complication of stroke,which seriously afects the rehabilitation of stroke patients.To date,the pathogenesis of PSD is unclear and efective treatments remain unavailable.Here,we established a mouse model of PSD through photothrombosis-induced focal ischemia.By using a combination of brain imaging,transcriptome sequencing,and bioinformatics analysis,we found that the hippocampus of PSD mice had a signifcantly lower metabolic level than other brain regions.RNA sequencing revealed a signifcant reduction of miR34b-3p,which was expressed in hippocampal neurons and inhibited the translation of eukaryotic translation initiation factor 4E(eIF4E).Furthermore,silencing eIF4E inactivated microglia,inhibited neuroinfammation,and abolished the depression-like behaviors in PSD mice.Together,our data demonstrated that insufcient miR34b-3p after stroke cannot inhibit eIF4E translation,which causes PSD by the activation of microglia in the hippocampus.Therefore,miR34b-3p and eIF4E may serve as potential therapeutic targets for the treatment of PSD.
基金funded by the National Natural Science Foundation of China (NSFC 81771959)the University Grants Committee Research Grants Council,Hong Kong (GRF 15207120)the Science and Tech-nology Innovation Committee of Shenzhen,China (2021Szvup142)。
文摘Post-stroke depression(PSD)has negative impacts on the daily life of stroke survivors and delays their neuro-logical recovery.However,traditional post-stroke rehabilitation mainly focused on motor restoration,whereas little attention was given to the affective deficits.Effective management of PSD,including diagnosis,intervention,and follow-ups,is essential for post-stroke rehabilitation.As an objective measurement of the nervous system,electroencephalography(EEG)has been applied to the diagnosis and evaluation of PSD.In this paper,we re-viewed the literature most related to the clinical applications of EEG for PSD and offered a cross-section that is useful for selecting appropriate approaches in practice.This study aimed to gather EEG-based empirical ev-idence for PSD diagnosis,review interventions for managing PSD,and analyze the evaluation approaches.In total,33 diagnostic studies and 19 intervention studies related to PSD and depression were selected from the literature.It was found that the EEG features analyzed by both band-based and nonlinear dynamic approaches were capable of quantifying the abnormal neural responses on the cortical level for PSD diagnosis and interven-tion evaluation/prediction.Meanwhile,EEG-based machine learning has also been applied to the diagnosis and evaluation of depression to automate and speed up the process,and the results have been promising.Although brain-computer interface(BCI)interventions have been widely applied to post-stroke motor rehabilitation and cognitive training,BCI emotional training has not been directly used in PSD yet.This review showed the need for understanding the cortical responses of PSD to improve its diagnosis and precision treatment.It also revealed that future post-stroke rehabilitation plans should include training sessions for motor,affect,and cognitive functions and closely monitor their improvements.
文摘The articles on the pathogenesis of post-stroke depression(PSD)and the acupuncture treatment mechanism of PSD from January 2010 through to June 2020 were retrieved from China National knowledge Infrastructure(CNKI),Wanfang Database,VIP China Science-Technology and National Social Sciences Database.In summary,the potential mechanism of acupuncture in treatment of PSD is explained from the following three aspects:acupuncture regulating monoamine neurotransmitters,acupuncture regulating neurotrophic factors and acupuncture regulating cytokines.The limitation and prospects of the current researches are also put forward so as to provide the references and to determine the research direction in the future.
