Posttraumatic stress disorder(PTSD)is a complex mental disorder notable for traumatic experience memory.Although current first-line treatments are linked with clinically important symptom reduction,a large proportion ...Posttraumatic stress disorder(PTSD)is a complex mental disorder notable for traumatic experience memory.Although current first-line treatments are linked with clinically important symptom reduction,a large proportion of patients retained to experience considerable residual symptoms,indicating pathogenic mechanism should be illustrated further.Recent studies reported that newly formed myelin could shape neural circuit function and be implicated in fear memory preservation.However,its role in PTSD remains to be elucidated.In this study,we adopted a restraint stress-induced PTSD mouse model and found that PTSD-related neuropsychiatric symptoms were accompanied by increased myelination in the posterior parietal cortex and hippocampus.Fluoxetine,but not risperidone or sertraline,has a more profound rescue effect on neuropsychological behaviors and myelin abnormalities.Further mechanistic experiments revealed that fluoxetine could directly interfere with oligodendroglial differentiation by upregulating Wnt signaling.Our data demonstrated the correlation between PTSD and abnormal myelination,suggesting that the oligodendroglial lineage could be a target for PTSD treatment.展开更多
A 68-year-old male was complained of chest pain for two years and fatigue for one week. He was admitted to other hospitals two years ago because of severe chest pain. A diagnosis of acute non-ST segment elevation myoc...A 68-year-old male was complained of chest pain for two years and fatigue for one week. He was admitted to other hospitals two years ago because of severe chest pain. A diagnosis of acute non-ST segment elevation myocardial infarction （NSTEMI） was made. But the coronary angiography was refused by himself. After effective conservative treatment, he got better and discharged. A regular administration of aspirin, metoprolol and simvastatin was taken. No recurrent sympotoms occurred. However, he felt fatigue and palpitation after 30-m walking one week ago without predisposing factors.展开更多
Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective stud...Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective study that included consecutive septic patients.Severity scores on the first day and peripheral circulating immune cell counts(at day 1,day 3,day 5 and day 7 of admission)were collected during each patient’s emergency intensive care unit stay.We assessed the associations of peripheral circulating immune cell counts and NLR with the severity of illness.The relationships between 28-day mortality and peripheral circulating immune cell counts and NLR with were evaluated using Cox proportional cause-specific hazards models.Results:A total of 216 patients diagnosed with sepsis caused by IAI were enrolled.The lymphocyte counts(days 1,3,5 and 7)and monocyte counts(days 3,5 and 7)were significantly lower in nonsurvivors(n=72)than survivors(n=144).The NLR values at each time point were significantly higher in non-survivors.The day 1 lymphocyte counts,as well as the monocyte counts,were significantly lower in the highest-scoring group,when stratified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores,than in the other groups(p<0.05).The day 1 NLR was significantly higher in the highest-scoring group than in the other groups(p<0.05).The day 5 and day 7 lymphocyte counts,day 3 and day 7 monocyte counts and day 7 NLR were significant predictors of 28-day mortality in the Cox proportional hazards models(day 5 lymphocyte count:hazard ratio,0.123(95%CI,0.055–0.279),p<0.001;day 7 lymphocyte count:hazard ratio,0.115(95%CI,0.052–0.254),p<0.001;day 3 monocyte count:hazard ratio,0.067(95%CI,0.005–0.861),p=0.038;day 7 monocyte count:hazard ratio,0.015(95%CI,0.001–0.158),p<0.001;day 7 NLR:hazard ratio,0.773(95%CI,0.659–0.905),p=0.001).Conclusions The results showed that circulating lymphocytes and monocytes were dramatically decreased within 7 days in non-survivors following sepsis from an IAI.Lymphocyte counts,monocyte counts and NLR appeared to be associated with the severity of illness,and they may serve as independent predictors of 28-day mortality in septic patients with IAIs.展开更多
Background:Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism(IHH)may produce adverse effects on the endocrine homeostasis and metabolism.This study aimed to compare basal s...Background:Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism(IHH)may produce adverse effects on the endocrine homeostasis and metabolism.This study aimed to compare basal serum adrenocorticotropic hormone(ACTH)and cortisol levels between male IHH patients and healthy controls.Moreover,this study compared the basal hypothalamic-pituitary-adrenal(HPA)axis in patients with and without nonalcoholic fatty liver disease(NAFLD),and also evaluated the relationship between basal HPA axis and NAFLD in male IHH patients.Methods:This was a retrospective case-control study involving 75 Chinese male IHH patients(mean age 21.4±3.8 years,range 1730 years)and 135 healthy controls after matching tbr gender and age.All subjects underwent physical examination and blood testing for serum testosterone,luteinizing hormone,follicle-stimulating hormone.ACTH,and cortisol and biochemical tests.Results:Higher basal serum ACTH levels(8.25±3.78 pmol/L vs.6.97±2.81 pmol/L)and lower cortisol levels(366.70±142.48 nmol/L vs.452.82±141.53 nmol/L)were observed ill male IHH patients than healthy subjects(all P〈0.05).IHH patients also showed higher metabolism parameters and higher prevalence rate of NAFLD(34.9%vs.4.4%)than the controls(all P〈0.05).Basal serum ACTH(9.91±4.98 pmol/L vs.7.60±2.96 pmol/L)and dehydroepiandrosterone sulfate(2123.7±925.8μg/L vs.1417.1±498.4μg/L)levels were significantly higher in IHH patients with NAFLD than those without NAFLD(all P〈0.05).We also found that basal serum ACTH levels were positively correlated with NAFLD(r=0.289,P〈0.05)and triglyceride levels(r-0.268,P〈0.05)in male IHH patients.Furthermore,NAFLD was independently associated with ACTH levels in male IHH patients by multiple linear regression analysis.Conclusions:The male IHH patients showed higher basal serum ACTH levels and lower cortisol levels than matched healthy controls.NAFLD was an independent associated factor for ACTH levels in male IHH patients.These preliminary findings provided evidence of the relationship between basal serum ACTH and NAFLD in male IHH patients.展开更多
基金supported by grants from the National Nature Science Foundation of China(32271034,32070964,82301703,32300791,and 81901378)Science and Technology Innovation Enhancement Project of Army Medical University(2022XQN40)+4 种基金National Key Research and Development Program of China(2021ZD0201703)Chongqing Natural Science Fund for Distinguished Young Scholars(CSTB2023NSCQ-JQX0030)Undergraduate Research Cultivation Project of Army Medical University(2020XBK16)Guangdong Basic and Applied Basic Research Foundation(2021A1515110268 and 2023A1515010651)Shenzhen Fundamental Research Program(RCBS20210706092411028 and JCYJ20210324121214039).
文摘Posttraumatic stress disorder(PTSD)is a complex mental disorder notable for traumatic experience memory.Although current first-line treatments are linked with clinically important symptom reduction,a large proportion of patients retained to experience considerable residual symptoms,indicating pathogenic mechanism should be illustrated further.Recent studies reported that newly formed myelin could shape neural circuit function and be implicated in fear memory preservation.However,its role in PTSD remains to be elucidated.In this study,we adopted a restraint stress-induced PTSD mouse model and found that PTSD-related neuropsychiatric symptoms were accompanied by increased myelination in the posterior parietal cortex and hippocampus.Fluoxetine,but not risperidone or sertraline,has a more profound rescue effect on neuropsychological behaviors and myelin abnormalities.Further mechanistic experiments revealed that fluoxetine could directly interfere with oligodendroglial differentiation by upregulating Wnt signaling.Our data demonstrated the correlation between PTSD and abnormal myelination,suggesting that the oligodendroglial lineage could be a target for PTSD treatment.
文摘A 68-year-old male was complained of chest pain for two years and fatigue for one week. He was admitted to other hospitals two years ago because of severe chest pain. A diagnosis of acute non-ST segment elevation myocardial infarction （NSTEMI） was made. But the coronary angiography was refused by himself. After effective conservative treatment, he got better and discharged. A regular administration of aspirin, metoprolol and simvastatin was taken. No recurrent sympotoms occurred. However, he felt fatigue and palpitation after 30-m walking one week ago without predisposing factors.
基金supported by grants from the Key Project of Military Medical Program of Chinese PLA(Nos.18CXZ026,BLJ18J006)the National Natural Science Foundation of China(No.81730057)the National Key Research and Development Program of China(No.2017YFC1103302).
文摘Background:The current study aimed to evaluate the value of immune cell counts and neutrophilto-lymphocyte ratio(NLR)when attempting to predict 28-day mortality.Methods:We conducted an observational retrospective study that included consecutive septic patients.Severity scores on the first day and peripheral circulating immune cell counts(at day 1,day 3,day 5 and day 7 of admission)were collected during each patient’s emergency intensive care unit stay.We assessed the associations of peripheral circulating immune cell counts and NLR with the severity of illness.The relationships between 28-day mortality and peripheral circulating immune cell counts and NLR with were evaluated using Cox proportional cause-specific hazards models.Results:A total of 216 patients diagnosed with sepsis caused by IAI were enrolled.The lymphocyte counts(days 1,3,5 and 7)and monocyte counts(days 3,5 and 7)were significantly lower in nonsurvivors(n=72)than survivors(n=144).The NLR values at each time point were significantly higher in non-survivors.The day 1 lymphocyte counts,as well as the monocyte counts,were significantly lower in the highest-scoring group,when stratified by the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores,than in the other groups(p<0.05).The day 1 NLR was significantly higher in the highest-scoring group than in the other groups(p<0.05).The day 5 and day 7 lymphocyte counts,day 3 and day 7 monocyte counts and day 7 NLR were significant predictors of 28-day mortality in the Cox proportional hazards models(day 5 lymphocyte count:hazard ratio,0.123(95%CI,0.055–0.279),p<0.001;day 7 lymphocyte count:hazard ratio,0.115(95%CI,0.052–0.254),p<0.001;day 3 monocyte count:hazard ratio,0.067(95%CI,0.005–0.861),p=0.038;day 7 monocyte count:hazard ratio,0.015(95%CI,0.001–0.158),p<0.001;day 7 NLR:hazard ratio,0.773(95%CI,0.659–0.905),p=0.001).Conclusions The results showed that circulating lymphocytes and monocytes were dramatically decreased within 7 days in non-survivors following sepsis from an IAI.Lymphocyte counts,monocyte counts and NLR appeared to be associated with the severity of illness,and they may serve as independent predictors of 28-day mortality in septic patients with IAIs.
基金Financial support and sponsorship This study was supported by a grant from National Natural Science Foundation of China(No.81170732).
文摘Background:Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism(IHH)may produce adverse effects on the endocrine homeostasis and metabolism.This study aimed to compare basal serum adrenocorticotropic hormone(ACTH)and cortisol levels between male IHH patients and healthy controls.Moreover,this study compared the basal hypothalamic-pituitary-adrenal(HPA)axis in patients with and without nonalcoholic fatty liver disease(NAFLD),and also evaluated the relationship between basal HPA axis and NAFLD in male IHH patients.Methods:This was a retrospective case-control study involving 75 Chinese male IHH patients(mean age 21.4±3.8 years,range 1730 years)and 135 healthy controls after matching tbr gender and age.All subjects underwent physical examination and blood testing for serum testosterone,luteinizing hormone,follicle-stimulating hormone.ACTH,and cortisol and biochemical tests.Results:Higher basal serum ACTH levels(8.25±3.78 pmol/L vs.6.97±2.81 pmol/L)and lower cortisol levels(366.70±142.48 nmol/L vs.452.82±141.53 nmol/L)were observed ill male IHH patients than healthy subjects(all P〈0.05).IHH patients also showed higher metabolism parameters and higher prevalence rate of NAFLD(34.9%vs.4.4%)than the controls(all P〈0.05).Basal serum ACTH(9.91±4.98 pmol/L vs.7.60±2.96 pmol/L)and dehydroepiandrosterone sulfate(2123.7±925.8μg/L vs.1417.1±498.4μg/L)levels were significantly higher in IHH patients with NAFLD than those without NAFLD(all P〈0.05).We also found that basal serum ACTH levels were positively correlated with NAFLD(r=0.289,P〈0.05)and triglyceride levels(r-0.268,P〈0.05)in male IHH patients.Furthermore,NAFLD was independently associated with ACTH levels in male IHH patients by multiple linear regression analysis.Conclusions:The male IHH patients showed higher basal serum ACTH levels and lower cortisol levels than matched healthy controls.NAFLD was an independent associated factor for ACTH levels in male IHH patients.These preliminary findings provided evidence of the relationship between basal serum ACTH and NAFLD in male IHH patients.
