[Objectives]To evaluate whether the level of serum uric acid in patients with bipolar disorder type I in their manic episode was different from that in healthy subjects,and to evaluate whether the level of serum uric ...[Objectives]To evaluate whether the level of serum uric acid in patients with bipolar disorder type I in their manic episode was different from that in healthy subjects,and to evaluate whether the level of serum uric acid is related to the severity of manic episode and the improvement of clinical symptoms.[Methods]A total of 70 patients with bipolar disorder type I in their manic episode were selected,their serum uric acid levels were measured at the beginning of the enrollment and at the end of the first,second and third week,and the clinical symptoms were evaluated with Young Mania Rating Scale(YMRS).65 healthy subjects were enrolled,and their serum uric acid levels were measured only at the beginning of the enrollment.[Results]The level of serum uric acid in patients with bipolar disorder type I in their manic episode was higher than that in healthy adults(t=8.153,p=0.039).At the end of the third week,the YMRS score and uric acid level of the patients were lower than those of the patients at the beginning of the enrollment(t=17.107,p=0.000;t=35.864,p=0.000).[Conclusions]The level of serum uric acid in patients with bipolar disorder type I in their manic episode was higher than that in healthy subjects,and the decrease of serum uric acid level may be related to the improvement of clinical symptoms.展开更多
BACKGROUND Nowadays there is an increasing use of transcranial magnetic stimulation(TMS)both in neurological and psychiatric fields.After Food and Drug Administration approval of TMS for the therapy of treatment-resis...BACKGROUND Nowadays there is an increasing use of transcranial magnetic stimulation(TMS)both in neurological and psychiatric fields.After Food and Drug Administration approval of TMS for the therapy of treatment-resistant depression,TMS has been widely used in the context of mood disorders(MD).However,growing reports regarding the possibility of developing hypomanic/manic switch(HMS)have generated concern regarding its use in MDs.AIM To investigate the actual risk of developing HMS due to TMS in the treatment of MD.METHODS We led our research on PubMed,Scopus and Web of Science on March 22,2020,in accordance to the PRISMA guidelines for systematic review.Only double blind/single blind studies,written in English and focused on the TMS treatment of MD,were included.A meta-analysis of repetitive TMS protocol studies including HMS was conducted using RevMan 5.4 software.The assessment of Risk of Bias was done using Cochrane risk of bias tool.This protocol was registered on PROSPERO with the CRD42020175811 code.RESULTS Twenty-five studies were included in our meta-analysis:Twenty-one double blind randomized controlled trials(RCT)and four single blind-RCT(no.of subjects involved in active stimulation=576;no.of subjects involved in sham protocol=487).The most frequently treated pathology was major depressive episode/major depressive disorder,followed by resistant depression,bipolar depression and other MD.The majority of the studies used a repetitive TMS protocol,and the left dorsolateral prefrontal cortex was the main target area.Side effects were reported in eight studies and HMS(described as greater energy,insomnia,irritability,anxiety,suicidal attempt)in four studies.When comparing active TMS vs sham treatment,the risk of developing HMS was not significantly different between conditions.CONCLUSION Applying the most usual protocols and the appropriate precautionary measures,TMS seems not to be related to HMS development.展开更多
Objective To explore the application value of progressive guided nursing and advanced empathic nursing in patients with manic episodes of bipolar disorder. Method to amount of computer random method will be our hospit...Objective To explore the application value of progressive guided nursing and advanced empathic nursing in patients with manic episodes of bipolar disorder. Method to amount of computer random method will be our hospital bipolar disorder manic patients 60 cases were divided into A (n = 30), B (n = 30) in the two groups, and in January 2020 - December 2021, during the expansion of medical research, given A set of routine nursing intervention, group B incremental guide senior care and empathy nursing intervention, and compare the effect of intervention. Results The total score of YMRS scale in group B was lower than that in group A, and the total score of WMS scale, THE total score of GQOL-74 scale and nursing satisfaction were higher than that in group A, with statistical significance (P < 0.05). Conclusion Gradually guided nursing and advanced empathy nursing intervention can effectively reduce the degree of mania in patients with bipolar disorder, and positively improve memory ability and quality of life, which has significant clinical application value and is worthy of further promotion and application.展开更多
Methylmalonic aciduria （MMA） is an autosomal recessive disorder of cobalamin （cbl） metabolism. Cobalamin C （cblC） disease is the most common type of MMA and is characteristically concurrent with homocystinemia ...Methylmalonic aciduria （MMA） is an autosomal recessive disorder of cobalamin （cbl） metabolism. Cobalamin C （cblC） disease is the most common type of MMA and is characteristically concurrent with homocystinemia （HCY） due to impaired synthesis of two active forms of cbl, namely adenosylcobalamin （AdoCbl） and methylcobalamin （MeCbl）. The estimated worldwide incidence of MMA ranges between 1：48,000 and 1：250,000. Mutations of the MMA and HCY type C protein （MMACtfC） gene are responsible for cblC disease and were first identified by Lerner-Ellis et aL in 2006.By the year 2016, more than 82 different MMACHC gene mutations have been reported （http：// www.hgmd.cf.ac.uk/ac/index.php）. Among these mutations, c.609G〉A （p.W203X） was reported to be the most frequent cblC mutation in Chinese patients.展开更多
目的探究奥卡西平联合喹硫平治疗对双相情感障碍躁狂发作患者临床症状及认知功能的影响。方法回顾性分析2021年1月~2024年1月期间在我院就诊的双相情感障碍躁狂发作患者临床资料,按照治疗方法不同分为对照组(予以喹硫平治疗)和观察组(...目的探究奥卡西平联合喹硫平治疗对双相情感障碍躁狂发作患者临床症状及认知功能的影响。方法回顾性分析2021年1月~2024年1月期间在我院就诊的双相情感障碍躁狂发作患者临床资料,按照治疗方法不同分为对照组(予以喹硫平治疗)和观察组(予以奥卡西平联合喹硫平治疗),采用1∶1最邻近匹配法进行倾向性评分匹配,最终每组各45例。比较治疗前和治疗1个月后两组患者的临床症状[临床总体印象疾病严重度量表-双相障碍版(clinical global impression severity scale-bipolar disorder version,CGI-BP)]、躁狂发作程度[躁狂量表(Bech-Rafaelsen Mania Rating Scale,BRMS)]、神经内分泌功能指标[血清甲状腺素(thyroid hormone,TH)、皮质醇(cortisol,Cor)、促甲状腺素(thyroid stimulating hormone,TSH)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)]和认知功能[认知功能相关连线测试量表(cognitive function related trail making test,TMT)],以及记录治疗期间两组患者不良反应发生情况。结果治疗1个月后,两组患者的CGIBP评分、BRMS评分、TH、Cor、ACTH、TMT量表时间较治疗前显著下降,且观察组低于对照组(P<0.05);两组患者的TSH较治疗前显著提高,且观察组高于对照组(P<0.05)。在治疗期间,观察组的不良反应发生率显著高于对照组(P<0.05)。结论奥卡西平联合喹硫平治疗能够有效缓解双相情感障碍躁狂发作患者症状,降低患者躁狂发作程度,改善神经内分泌功能和认知功能,具有较好的安全性。展开更多
目的:观察双相I型障碍(Bipolar-disorder Type Ⅰ,BPDTI)躁狂发作患者认知功能损害中冲动性在其中的作用。方法:选取本院2024年2月至2024年12月期间收治的180例BPDTI躁狂发作患者作为躁狂组,并另选取同期经心理测试为正常的志愿者180例...目的:观察双相I型障碍(Bipolar-disorder Type Ⅰ,BPDTI)躁狂发作患者认知功能损害中冲动性在其中的作用。方法:选取本院2024年2月至2024年12月期间收治的180例BPDTI躁狂发作患者作为躁狂组,并另选取同期经心理测试为正常的志愿者180例为健康组。采用的冲动Barratt-11量表(BIS-11)、MATRICS共识认知成套测验(MCCB)进行冲动性、认知功能调查与评价,并展开相关性分析与危险因素分析。结果:在BIS-11量表中,两组在无计划因子无统计学差异(P>0.05),两组在认知、运动因子与总分上有显著差异(P<0.05)。躁狂组的信息处理速度、工作记忆、词语学习、视觉学习、社会认知、推理与问题解决、注意警觉性等MCCB评分明显低于健康组(P<0.05)。BIS-11总分及认知冲动性因子与MCCB总分、词语学习的关系呈现负相关性(P<0.05);BIS-11量表中的运动因子与MCCB总分、工作记忆因子呈负相关性(P<0.05);BIS-11量表中的无计划因子除与MCCB总分、词语学习、信息处理速度呈负相关性(P<0.05)。BIS-11、受教育年限为BPDTI躁狂发作的影响因素(P<0.05)。结论:BPDTI躁狂发作者存在高冲动性和认知功能损害,高冲动性、受教育年限是躁狂发作的影响因素,高冲动性通过对应脑区影响认知功能,加重病情。展开更多
目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分...目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分为正常泌乳素(Prolactin,PRL)组(29例)和高泌乳素血症(Hyperprolactinemia,HPRL)组(25例),比较两组的临床指标。用Spearman相关分析探讨PRL与各项临床指标的相关性。用Logistic回归分析明确HPRL发生的危险因素。结果:(1)育龄期女性躁狂发作住院患者HPRL的患病率为46.3%;(2)与正常PRL组相较,HPRL组的患者月经更不规律,腰围及BMI更低,游离甲状腺素(Free Thyroxine,FT4)及高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)均更高,差异均有统计学意义(P<0.05);(3)Spearman相关分析结果显示,PRL与FT4、HDL-C呈正相关(r=0.385,0.405;P<0.05),PRL与腰围、BMI呈负相关(r=-0.425,-0.408;P<0.05);(4)多元线性回归分析结果显示,PRL与严重躁狂症状呈正相关(B=12.044,P<0.05);(5)Logistic回归分析结果显示,月经越不规律,HPRL的患病风险越高(OR=0.130);FT4越高,HPRL的患病风险越高(OR=1.054),HDL-C越高,HPRL的患病风险越高(OR=1.635)。结论:育龄期女性躁狂发作住院患者HPRL的患病率46.3%,高于一般人群;月经不规律、高FT4及高HDL-C为患轻度HPRL的危险因素;轻度泌乳素水平升高对患者的体质量有保护作用,但会对生育能力及疾病严重程度产生不良影响。展开更多
文摘[Objectives]To evaluate whether the level of serum uric acid in patients with bipolar disorder type I in their manic episode was different from that in healthy subjects,and to evaluate whether the level of serum uric acid is related to the severity of manic episode and the improvement of clinical symptoms.[Methods]A total of 70 patients with bipolar disorder type I in their manic episode were selected,their serum uric acid levels were measured at the beginning of the enrollment and at the end of the first,second and third week,and the clinical symptoms were evaluated with Young Mania Rating Scale(YMRS).65 healthy subjects were enrolled,and their serum uric acid levels were measured only at the beginning of the enrollment.[Results]The level of serum uric acid in patients with bipolar disorder type I in their manic episode was higher than that in healthy adults(t=8.153,p=0.039).At the end of the third week,the YMRS score and uric acid level of the patients were lower than those of the patients at the beginning of the enrollment(t=17.107,p=0.000;t=35.864,p=0.000).[Conclusions]The level of serum uric acid in patients with bipolar disorder type I in their manic episode was higher than that in healthy subjects,and the decrease of serum uric acid level may be related to the improvement of clinical symptoms.
文摘BACKGROUND Nowadays there is an increasing use of transcranial magnetic stimulation(TMS)both in neurological and psychiatric fields.After Food and Drug Administration approval of TMS for the therapy of treatment-resistant depression,TMS has been widely used in the context of mood disorders(MD).However,growing reports regarding the possibility of developing hypomanic/manic switch(HMS)have generated concern regarding its use in MDs.AIM To investigate the actual risk of developing HMS due to TMS in the treatment of MD.METHODS We led our research on PubMed,Scopus and Web of Science on March 22,2020,in accordance to the PRISMA guidelines for systematic review.Only double blind/single blind studies,written in English and focused on the TMS treatment of MD,were included.A meta-analysis of repetitive TMS protocol studies including HMS was conducted using RevMan 5.4 software.The assessment of Risk of Bias was done using Cochrane risk of bias tool.This protocol was registered on PROSPERO with the CRD42020175811 code.RESULTS Twenty-five studies were included in our meta-analysis:Twenty-one double blind randomized controlled trials(RCT)and four single blind-RCT(no.of subjects involved in active stimulation=576;no.of subjects involved in sham protocol=487).The most frequently treated pathology was major depressive episode/major depressive disorder,followed by resistant depression,bipolar depression and other MD.The majority of the studies used a repetitive TMS protocol,and the left dorsolateral prefrontal cortex was the main target area.Side effects were reported in eight studies and HMS(described as greater energy,insomnia,irritability,anxiety,suicidal attempt)in four studies.When comparing active TMS vs sham treatment,the risk of developing HMS was not significantly different between conditions.CONCLUSION Applying the most usual protocols and the appropriate precautionary measures,TMS seems not to be related to HMS development.
文摘Objective To explore the application value of progressive guided nursing and advanced empathic nursing in patients with manic episodes of bipolar disorder. Method to amount of computer random method will be our hospital bipolar disorder manic patients 60 cases were divided into A (n = 30), B (n = 30) in the two groups, and in January 2020 - December 2021, during the expansion of medical research, given A set of routine nursing intervention, group B incremental guide senior care and empathy nursing intervention, and compare the effect of intervention. Results The total score of YMRS scale in group B was lower than that in group A, and the total score of WMS scale, THE total score of GQOL-74 scale and nursing satisfaction were higher than that in group A, with statistical significance (P < 0.05). Conclusion Gradually guided nursing and advanced empathy nursing intervention can effectively reduce the degree of mania in patients with bipolar disorder, and positively improve memory ability and quality of life, which has significant clinical application value and is worthy of further promotion and application.
文摘Methylmalonic aciduria （MMA） is an autosomal recessive disorder of cobalamin （cbl） metabolism. Cobalamin C （cblC） disease is the most common type of MMA and is characteristically concurrent with homocystinemia （HCY） due to impaired synthesis of two active forms of cbl, namely adenosylcobalamin （AdoCbl） and methylcobalamin （MeCbl）. The estimated worldwide incidence of MMA ranges between 1：48,000 and 1：250,000. Mutations of the MMA and HCY type C protein （MMACtfC） gene are responsible for cblC disease and were first identified by Lerner-Ellis et aL in 2006.By the year 2016, more than 82 different MMACHC gene mutations have been reported （http：// www.hgmd.cf.ac.uk/ac/index.php）. Among these mutations, c.609G〉A （p.W203X） was reported to be the most frequent cblC mutation in Chinese patients.
文摘目的探究奥卡西平联合喹硫平治疗对双相情感障碍躁狂发作患者临床症状及认知功能的影响。方法回顾性分析2021年1月~2024年1月期间在我院就诊的双相情感障碍躁狂发作患者临床资料,按照治疗方法不同分为对照组(予以喹硫平治疗)和观察组(予以奥卡西平联合喹硫平治疗),采用1∶1最邻近匹配法进行倾向性评分匹配,最终每组各45例。比较治疗前和治疗1个月后两组患者的临床症状[临床总体印象疾病严重度量表-双相障碍版(clinical global impression severity scale-bipolar disorder version,CGI-BP)]、躁狂发作程度[躁狂量表(Bech-Rafaelsen Mania Rating Scale,BRMS)]、神经内分泌功能指标[血清甲状腺素(thyroid hormone,TH)、皮质醇(cortisol,Cor)、促甲状腺素(thyroid stimulating hormone,TSH)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)]和认知功能[认知功能相关连线测试量表(cognitive function related trail making test,TMT)],以及记录治疗期间两组患者不良反应发生情况。结果治疗1个月后,两组患者的CGIBP评分、BRMS评分、TH、Cor、ACTH、TMT量表时间较治疗前显著下降,且观察组低于对照组(P<0.05);两组患者的TSH较治疗前显著提高,且观察组高于对照组(P<0.05)。在治疗期间,观察组的不良反应发生率显著高于对照组(P<0.05)。结论奥卡西平联合喹硫平治疗能够有效缓解双相情感障碍躁狂发作患者症状,降低患者躁狂发作程度,改善神经内分泌功能和认知功能,具有较好的安全性。
文摘目的:观察双相I型障碍(Bipolar-disorder Type Ⅰ,BPDTI)躁狂发作患者认知功能损害中冲动性在其中的作用。方法:选取本院2024年2月至2024年12月期间收治的180例BPDTI躁狂发作患者作为躁狂组,并另选取同期经心理测试为正常的志愿者180例为健康组。采用的冲动Barratt-11量表(BIS-11)、MATRICS共识认知成套测验(MCCB)进行冲动性、认知功能调查与评价,并展开相关性分析与危险因素分析。结果:在BIS-11量表中,两组在无计划因子无统计学差异(P>0.05),两组在认知、运动因子与总分上有显著差异(P<0.05)。躁狂组的信息处理速度、工作记忆、词语学习、视觉学习、社会认知、推理与问题解决、注意警觉性等MCCB评分明显低于健康组(P<0.05)。BIS-11总分及认知冲动性因子与MCCB总分、词语学习的关系呈现负相关性(P<0.05);BIS-11量表中的运动因子与MCCB总分、工作记忆因子呈负相关性(P<0.05);BIS-11量表中的无计划因子除与MCCB总分、词语学习、信息处理速度呈负相关性(P<0.05)。BIS-11、受教育年限为BPDTI躁狂发作的影响因素(P<0.05)。结论:BPDTI躁狂发作者存在高冲动性和认知功能损害,高冲动性、受教育年限是躁狂发作的影响因素,高冲动性通过对应脑区影响认知功能,加重病情。
文摘目的:探讨育龄期女性双相障碍躁狂发作患者共病高泌乳素血症的患病率及危险因素,为临床预防、治疗及改善生育能力提供依据。方法:选取2018年12月至2020年8月某院收治的入院时未服药的54例育龄期女性双相障碍躁狂发作患者为研究对象,分为正常泌乳素(Prolactin,PRL)组(29例)和高泌乳素血症(Hyperprolactinemia,HPRL)组(25例),比较两组的临床指标。用Spearman相关分析探讨PRL与各项临床指标的相关性。用Logistic回归分析明确HPRL发生的危险因素。结果:(1)育龄期女性躁狂发作住院患者HPRL的患病率为46.3%;(2)与正常PRL组相较,HPRL组的患者月经更不规律,腰围及BMI更低,游离甲状腺素(Free Thyroxine,FT4)及高密度脂蛋白胆固醇(High Density Lipoprotein Cholesterol,HDL-C)均更高,差异均有统计学意义(P<0.05);(3)Spearman相关分析结果显示,PRL与FT4、HDL-C呈正相关(r=0.385,0.405;P<0.05),PRL与腰围、BMI呈负相关(r=-0.425,-0.408;P<0.05);(4)多元线性回归分析结果显示,PRL与严重躁狂症状呈正相关(B=12.044,P<0.05);(5)Logistic回归分析结果显示,月经越不规律,HPRL的患病风险越高(OR=0.130);FT4越高,HPRL的患病风险越高(OR=1.054),HDL-C越高,HPRL的患病风险越高(OR=1.635)。结论:育龄期女性躁狂发作住院患者HPRL的患病率46.3%,高于一般人群;月经不规律、高FT4及高HDL-C为患轻度HPRL的危险因素;轻度泌乳素水平升高对患者的体质量有保护作用,但会对生育能力及疾病严重程度产生不良影响。
