Effect of the combination of cognitive behavioral therapy and oral paroxetine hydrochloride in patients with post-stroke depression

Purpose: To determine the effects of combined use of cognitive behavioral therapy (CBT) and paroxetine hydrochloride tablets in patients with post-stroke depression (PSD), and its effect on scores on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL). Methods: Clinical data for 96 patients with PSD who were treated in Dongying Traditional Chinese Hospital, Dongying City, China from June 2018 to June 2019 were retrospectively analyzed. Patients who met the inclusion criteria were divided into treatment group (TG, n = 48) and reference group (RG, n = 48) based on odd and even hospitalization numbers. Both groups received conventional treatment, but RG patients were in addition given clopidogrel, while TG received CBT in combination with paroxetine hydrochloride tablets. Clinical indices were evaluated in both groups before and after treatment. Moreover, therapeutic effects in the two different treatment methods on PSD, as well as on Hamilton Rating Scale for Depression (HAMD) and Stroke Specific Quality of Life Scale (SS-QOL) scores were analyzed. Results: After treatment, TG had lower HAMD score (p < 0.001), lower scores on modified Rankin scale, and few incidences of adverse reactions at 3, 7, 15 and 30 days of treatment (p < 0.05), but higher total clinical effectiveness and mean SS-QOL score (p < 0.05), when compared with RG. Conclusion: Combined use of CBT and oral paroxetine hydrochloride tablets may be a promising strategy for treating depression and enhancing the quality of life of PSD patients, as it greatly improves neurological deficit and prognosis. However, further clinical trials should be carried out prior to introducing it in clinical practice

Causal association of gastroesophageal reflux disease with obstructive sleep apnea and sleep-related phenotypes: a bidirectional two-sample Mendelian randomization study

BackgroundThe interactions and associations between obstructive sleep apnea (OSA), sleep-related phenotypes (SRPs), and gastroesophageal reflux disease (GERD) are complex, thus it is hard to explore the effect and direction of causalities.Study objectivesA bidirectional Mendelian randomization (MR) study was performed to explore causal associations of GERD with OSA and SRPs (including insomnia, morningness, sleep duration, ease of getting up, daytime napping, daytime dozing, and snoring).MethodsFirst, we gathered summary statistics from publicly available databases. Subsequently, we identified single-nucleotide polymorphisms without strong linkage (r2 ≤ 0.001) by referencing relevant genome-wide association studies that met genome-wide significance criteria. Our primary analysis relied on inverse variance weighted to estimate the causal relationship. To ensure the validity of our findings, we also conducted several sensitivity analyses. These included MR Pleiotropy RESidual Sum and Outlier to detect and correct for potential pleiotropic effects, MR-Egger to assess directional pleiotropy, and weighted median analysis to further evaluate heterogeneity and pleiotropy. For the initial MR analysis, when causality was indicated by the results, instrumental variables that were significantly linked to the aforementioned confounding factors were removed. We will re-analyze the data after excluding outcome-related single nucleotide polymorphisms to confirm that the results are still consistent with the previous results.ResultsGERD was found to increase the risk of OSA (OR = 1.53, 95% CI = 1.37–1.70, p = 5.3 × 10−15), insomnia (OR = 1.14, 95% CI = 1.10–1.19, p = 1.3 × 10−10), snoring (OR = 1.09, 95% CI = 1.04–1.13, p = 6.3 × 10−5) and less sleep duration (OR = 0.94, 95% CI = 0.91–0.97, p = 3.7 × 10−4). According to the reverse-direction analysis, there is an elevated risk of GERD associated with OSA (OR = 1.07, 95% CI = 1.02–1.12, p = 0.005), insomnia (OR = 1.95, 95% CI = 1.60–2.37, p = 1.92 × 10−11) and snoring (OR = 1.74, 95% CI = 1.37–2.21, p = 4.4 × 10−6).ConclusionGenetic susceptibility to GERD can elevate the likelihood of experiencing insomnia, snoring, and OSA, in addition to diminishing sleep duration. Conversely, a reverse MR analysis indicates that ameliorating any one of insomnia, snoring, or OSA can mitigate the risk of developing GERD

Environmentally friendly concrete material with early strength and fast hardening using coal as an aggregate: a case for supporting empty roadways

In order to facilitate ventilation or transportation, many coal mines usually excavate an empty roadway in the middle of the mining working face. Under the influence of mining pressure, empty roadways are easily damaged, seriously threatening coal mines’ safety. Because the traditional support method of the empty roadway has the problems of low efficiency, high cost, and low strength, this paper researches the coal-based concrete support material with better effect. The grading test of coal aggregate was carried out, and it was found that the percentage of small-size aggregate greatly influenced the reduction of aggregate porosity in the stacked state. To solve the problems of the high cost of strengthening support methods such as high water material support in empty roadways, which could be more conducive to recovery and reduce coal quality. The research on empty roadways supports concrete material with coal as aggregate, making the working face recover coal resources safely and efficiently. The optimum gradation test of the total is to enhance the strength of support and solve the problem of low power and difficult cementation of coal. Based on the hydration analysis of cementitious material, the coal-based concrete, mainly composed of low-cost slag, is determined. The cementitious material with simple composition, rapid setting, and fast hardening was found. It is proved that the mechanical properties and molding effect of coal-based concrete support composed of gypsum, GGBFS, and clinkercement are better than those of commercial cement. The structural model of “surrounding rock-empty roadways-coal pillar-support” is established. The calculation method and check basis of empty roadways support resistance N1 are obtained. The results of industrial application verified that coal-based concrete could effectively protect empty roadways without affecting the productivity of coal mines

Role of miR-148a in Mitigating Hepatic Ischemia-Reperfusion Injury by Repressing the TLR4 Signaling Pathway via Targeting CaMKIIα in Vivo and in Vitro

Background/Aims: Hepatic ischemia-reperfusion (I/R) injury, which is mainly induced by inflammation and unstable intracellular ions, is a major negative consequence of surgery that compromises hepatic function. However, the exact mechanisms of liver I/R injury have not been determined. Positive crosstalk with the Ca2+/CaMKII pathway is required for complete activation of the TLR4 pathway and inflammation. We previously found that miR-148a, which decreased in abundance with increasing reperfusion time, targeted and repressed the expression of CaMKIIα. In the present study, we examined the role of the miR-148a machinery in I/R-induced Ca2+/CaMKII and TLR4 signaling changes, inflammation, and liver dysfunction in vivo and in vitro. Methods: Liver function was evaluated by serum aminotransferase levels and hematoxylin-eosin (HE) staining. Inflammatory factors were detected by enzyme-linked immunosorbent assay. Gene and protein expression were assessed by RT-PCR and western blot. Small interfering RNA was used to silence target gene expression. HE staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to measure hepatic tissue apoptosis. These assays were performed to identify factors upregulated in hepatic I/R injury and downregulated by miR-148a. Results: We manifested that expression of CaMKIIα and phosphorylation of TAK1 and IRF3 were elevated in hypoxia/reoxygenation (H/R)-treated primary Kupffer cells (KCs) and liver tissue of I/R-treated mice, but these effects were attenuated by treatment with miR-148a mimic and were accompanied by the alleviation of liver dysfunction and hepatocellular apoptosis. Luciferase reporter experiments showed that miR148a suppressed luciferase activity by almost 60%. Moreover, knockdown of CaMKIIα in H/R KCs led to significant deficiencies in p-TAK1, P-IRF3, IL-6, and TNF-α, which was consistent with the effects of miR-148a overexpression. Otherwise, the same trend of activation of TAK1 and IRF3 and inflammatory factors in vitro was observed in the siTAK1 + siIRF3 group compared with the siCaMKIIα group. Conclusion: Taken together, we conclude that miR-148a may mitigate hepatic I/R injury by ameliorating TLR4-mediated inflammation via targeting CaMKIIα in vitro and in vivo

The nucleus accumbens functional connectivity in patients with insomnia using resting-state fMRI

BackgroundThe aim of this study was to investigate the functional abnormalities between the nucleus accumbens (NAc) and the whole brain in individuals with Insomnia Disorder (ID) using resting-state functional magnetic resonance imaging (fMRI). Additionally, the study aimed to explore the underlying neural mechanisms of ID.MethodsWe enrolled 18 participants with ID and 16 normal controls (NC). Resting-state functional connectivity (FC) between the NAc and the whole brain voxels was calculated and compared between the two groups to identify differential brain region. Receiver operating characteristic (ROC) curve analysis was employed to assess the ability of differential features to distinguish between groups. Furthermore, Pearson correlation analysis was performed to examine the relationship between neurocognitive scores and differential features.ResultsThe ID group exhibited significantly reduced FC values in several brain regions, including the right supplementary motor area, the bilateral middle frontal gyrus, the bilateral median cingulate and paracingulate gyri and the left precuneus. The area under the curve (AUC) of the classification model based on FC in these brain regions was 83.3%. Additionally, the abnormal functional changes observed in ID patients were positively correlated with the Fatigue Severity Scale (R = 0.650, p = 0.004).ConclusionThese findings suggest that the NAc may play a crucial role in the diagnosis of ID and could serve as a potential imaging biomarker, providing insights into the underlying neural mechanisms of the disorder